Purpose: To systematically evaluate the different efficacy among generally used drugs for stent-related symptoms (SRS) with the method of network meta-analysis.
Methods: A systematic search was performed in the US National Library of Medicine's life science database (Medline), Embase, the Cochrane Central Register of Controlled Trials, and the Cochrane Database for Systematic Reviews before December 2017. Analysis was performed under multivariate random-effects network model and effects of drugs were ranked with surface under the cumulative ranking (SUCRA) probabilities.
Results: 19 trials with 2036 patients investigating 4 different intervention including tamsulosin (Tam), alfuzosin (Alfu), solifenacin (Soli) and combination of Tam and Solif were finally included in our analysis. Tam plus Soli had the highest SUCRA on all aspects of ureteral stent symptom questionnaire: urinary symptoms (86.2%), body pain (85.0%), general health (80.5%), work performance (72.0%) and sexual performance (84.4%). Except for pain relief, Soli showed higher SUCRA than Tam or Alfu in rest respects. Tam and Alfu showed similar SUCRA on urinary symptoms (53.0 vs 48.7%) and body pain relief (61.9 vs 62.9%).
Conclusions: Tam plus Soli might be the most effective intervention for SRSs. As for monotherapy, Soli showed advantages in most respects except for pain relief compared to Tam or Alfu. Tam and Alfu showed similar efficacy on urinary symptoms and body pain relief.
Keywords: Drug therapies; Network meta-analysis; Ureteral stent-related symptoms.