The hemodynamic interactions of combination therapy with α-blockers and phosphodiesterase-5 inhibitors compared to monotherapy with α-blockers: a systematic review and meta-analysis.

The present study systematically reviewed the safety of combined treatment with an alpha blocker and phosphodiesterase-5 inhibitor. The study was performed according to the PRISMA statement. The included studies were randomized controlled trials that included at least one group on alpha-blocker monotherapy and one group on a combined treatment with an alpha blocker and phosphodiesterase-5 inhibitor. The primary endpoints were the hemodynamic effects of the two groups, specifically the clinically significant changes and a positive orthostatic test. The secondary endpoints were the adverse events of the two treatment modalities. A total of 6687 studies were screened, and 19 randomized controlled trials were eligible for the meta-analysis. The combined treatment more often produced a clinically significant hemodynamic change with an MD of 4.73 (CI 1.25, 17.94; I The combined treatment may produce a clinically significant hemodynamic change. The combination of alpha blocker and phosphodiesterase-5 inhibitor was safe because it did not increase the rate of adverse events due to hypotension.