Efficiency and safety of the drug adenoprosin in patients with prostate diseases. A systematic review and meta-analysis

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Abstract

Introduction. Currently, a large number of studies of drugs of biological origin for the treatment of patients with chronic prostatitis (CP) have been carried out. The entomological drug Adenoprosin, which is based on the biomass of insect larvae of Lymantria dispar, has demonstrated efficiency, primarily due to its anti-inflammatory effect. A large body of literature dictate the need for systematization of the results.

Aim. To carry out a systematic review and meta-analysis for evaluating the efficiency and safety of Adenoprosin for the treatment of patients with CP and/or BPH.

Material and methods. A systematic review and meta-analysis according to the PRISMA protocol was carried out. For a literature search the following databases were chosen: Scopus, MEDLINE, Elibrary, Google Scholar and Cyberleninka, using the keyword “chronic prostatitis, benign prostatic hyperplasia” and “Adenoprosin”. Randomized clinical trials were included in the analysis. Scores were assessed before treatment and after 4 weeks.

Results. A total of 11 studies met the inclusion criteria. The experimental group was treated with Adenoprosin in combination with standard therapy, while in the control group patients received standard therapy alone.

A significant benefit from the addition of Adenoprosin was confirmed by the change in the pain domain of the NIH-CPSI questionnaire (-2.06 (95%CI: -3.32, -0.45); p<0.01) and the sum of NIH-CPSI scores (-3.39 (95%CI: -5.66, -1.12); p=0.01), IPSS score (-2.51 (95%CI: -4.47, -0.56); p=0.01), IIEF-5 questionnaire score (+2.68 (95%CDI: 2.08; 3.28), p<0.01), and Qmax (+2.34 ml/s (95%CI: 0.27, 4.41); p=0.04).

Conclusion. Adding Adenoprosin to the standard therapy in patients with CP, including those with BPH, significantly improves lower urinary tract symptoms and erectile function (based on NIH-CPSI, IPSS, IIEF-5 and uroflowmetry). There were no differences with the standard therapy in QoL, prostate volume and postvoid residual, and a number of leukocytes in expressed prostatic secretions were observed. Some authors report improvement of ejaculate parameters during therapy with Adenoprosin. However, this fact however requires further study.

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About the authors

А. О. Morozov

Institute for Urology and Reproductive Health, Sechenov University

Email: morozov_a_o_1@staff.sechenov.ru

Ph.D., senior researcher

Russian Federation, Moscow

Е. Yu. Timofeeva

Institute for Clinical medicine named after N.V. Sklifosovsky, Sechenov University

Email: katetimofeeva_04@mail.ru

student

Russian Federation, Moscow

А. Yu. Suvorov

«Digital Biodesign and Personalized Healthcare» World-Class Research Center, Sechenov University

Email: suvorov_a_yu_1@staff.sechenov.ru

chief statistician

Russian Federation, Moscow

S. N. Allenov

Institute for Urology and Reproductive Health, Sechenov University

Email: allenov_s_n@staff.sechenov.ru

Ph.D., Head of Treatment and Diagnostic Department №4

Russian Federation, Moscow

L. G. Spivak

Institute for Urology and Reproductive Health, Sechenov University

Author for correspondence.
Email: leonid.spivak@gmail.com

Ph.D., MD,  Professor

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. NIH-CPSI questionnaire, pain domain. Forest plot and sensitivity analysis

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3. Fig. 2. NIH-CPSI questionnaire, total points. Forest plot and sensitivity analysis

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4. Fig. 3. IPSS questionnaire, total points. Forest plot and sensitivity analysis

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5. Fig. 4. NIH-CPSI, QoL domain. Forest plot and sensitivity analysis

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6. Fig. 5. ICEF-5. Forest plot and sensitivity analysis

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7. Fig. 6. Qmax. Forest plot and sensitivity analysis

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8. Fig. 7. Leukocytes in the prostate secretion. Forest plot and sensitivity analysis

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9. Fig. 8. Residual urine. Forest plot and sensitivity analysis

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10. Fig. 9. Prostate volume. Forest plot and sensitivity analysis

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