Vela-Navarrete, RemigioAlcaraz, AntonioRodríguez-Antolín, AlfredoMiñana López, BernardinoFernández-Gómez, Jesús MAngulo, Javier CCastro Díaz, DavidRomero-Otero, JavierBrenes, Francisco JCarballido, JoaquínMolero García, José MªFernández-Pro Ledesma, AntonioCózar Olmos, José ManuelManasanch Dalmau, JoséSubirana Cachinero, IsaacHerdman, MichaelFicarra, Vincenzo2023-01-252023-01-252018-06-06http://hdl.handle.net/10668/12391To comprehensively evaluate the efficacy and safety of the hexanic extract of Serenoa repens (HESr, Permixon® ; Pierre Fabre Médicament, Castres, France), at a dose of 320 mg daily, as monotherapy for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH). We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) and prospective observational studies in patients with LUTS/BPH identified through searches in Medline, Web of Knowledge (Institute for Scientific Information), Scopus, the Cochrane Library, and bibliographic references up to March 2017. Articles studying S. repens extracts other than Permixon were excluded. Data were collected on International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax ), nocturia, quality of life, prostate volume, sexual function, and adverse drug reactions (ADRs). Data obtained from RCTs and observational studies were analysed jointly and separately using a random effects model. A sub-group analysis was performed of studies that included patients on longer-term treatment (≥1 year). Data from 27 studies (15 RCTs and 12 observational studies) were included for meta-analysis (total N = 5 800). Compared with placebo, the HESr was associated with 0.64 (95% confidence interval [CI] -0.98 to -0.31) fewer voids/night (P The present meta-analysis, which includes all available RCTs and observational studies, shows that the HESr (Permixon) reduced nocturia and improved Qmax compared with placebo and had a similar efficacy to tamsulosin and short-term 5-ARI in relieving LUTS. HESr (Permixon) appears to be an efficacious and well-tolerated therapeutic option for the long-term medical treatment of LUTS/BPH.enAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Serenoa repensLUTS/BPHPermixonhexanic extractmeta-analysissystematic reviewAndrogen AntagonistsBiomarkersHumansInflammationLower Urinary Tract SymptomsMaleObservational Studies as TopicPhytotherapyPlant ExtractsProstatic HyperplasiaRandomized Controlled Trials as TopicSerenoaTreatment Outcomeresearch article29694707open access10.1111/bju.143621464-410Xhttps://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/bju.14362