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Kurosawa M, Tsujimura A, Morino J, Anno Y, Yoshiyama A, Kure A, Uesaka Y, Nozaki T, Shirai M, Kobayashi K, Horie S. Efficacy and patient satisfaction of low-intensity shockwave treatment for erectile dysfunction in a retrospective real-world study in Japan. Int J Urol 2022; 30:375-380. [PMID: 36575829 DOI: 10.1111/iju.15135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To clarify the efficacy of low-intensity extracorporeal shockwave therapy for patients with erectile dysfunction, compare the efficacy between two types of lithotripters (ED1000 [focused type] and Renova [linear type]), and detect factors indicative of therapeutic gain with the treatment. METHODS This retrospective study included 76 patients (52.8 ± 11.7 years) treated by ED1000 (12 times over 9 weeks) and 484 patients (52.5 ± 11.6 years) treated by Renova (4 times over 4 weeks). Age, sexual symptoms scores, and blood examinations were assessed. Efficacy was judged by improvement of the scores and patient satisfaction and compared between patients at 1 month after treatment with the lithotripters. Independent factors influencing efficacy by Renova were also assessed. RESULTS Sexual symptom scores were improved significantly by both lithotripters, although the changes in the scores did not differ significantly between them. Efficacy rate as judged by patient satisfaction was 65.8% with the ED1000 and 71.1% with Renova, also without significant difference. Among several factors including age, sexual symptoms scores, endocrinological factors, metabolic factors, and the rate of phosphodiesterase type 5 inhibitor use, only age was found to be an independent factor influencing the efficacy of Renova. CONCLUSION We clearly showed the high efficacy of both lithotripters. Although the efficacy rate did not differ between them, we speculated that the fewer treatment sessions needed with the Renova versus the ED1000 would be a great advantage for patients. We also suggest that Renova should be recommended for patients younger than 70 years of age.
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Affiliation(s)
- Makoto Kurosawa
- Department of Urology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Akira Tsujimura
- Department of Urology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Junki Morino
- Department of Urology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Yuta Anno
- Department of Urology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Azusa Yoshiyama
- Department of Urology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Akimasa Kure
- Department of Urology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Yuka Uesaka
- Department of Urology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Taiji Nozaki
- Department of Urology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - Masato Shirai
- Department of Urology, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | | | - Shigeo Horie
- Department of Urology, Juntendo University, Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
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Narukawa T, Soh J, Kanemitsu N, Harikai S, Fujihara A, Ukimura O. Efficacy of testosterone replacement therapy plus alternate-day tadalafil for patients with late-onset hypogonadism: An open-label, randomized, crossover study. Int J Urol 2020; 28:376-381. [PMID: 33342003 DOI: 10.1111/iju.14468] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/19/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine the efficacy and safety of combination treatment with testosterone replacement therapy plus alternate-day tadalafil (10 mg) in patients with late-onset hypogonadism. METHODS In this open-label, randomized, crossover study, 29 patients with late-onset hypogonadism were randomly assigned to receive testosterone replacement therapy for 12 weeks followed by combination treatment for 12 weeks (Group 1) or combination treatment for 12 weeks followed by testosterone replacement therapy (Group 2). Symptom questionnaires were administered and blood tests were performed prior to and following each treatment to assess safety and efficacy. At the end of the study, participants were asked about their treatment preferences. RESULTS An adverse effect, a rheum symptom, occurred in only one participant, and 26 participants completed the study without any toxicity. Scores on the Aging Male Symptoms scale and the modified short version of the International Index of Erectile Function, and Overactive Bladder Symptom scores were significantly improved in the combination treatment phase of Group 2, whereas no significant difference between the phases were observed in Group 1. In total, 12 out of the 14 participants in Group 1 and 11 out of the 12 participants in Group 2 preferred combination treatment, which reached statistical significance (P = 0.008 and 0.004 for Groups 1 and 2, respectively). CONCLUSIONS Testosterone replacement therapy with add-on alternate-day tadalafil is a safe and satisfactory treatment for patients with late-onset hypogonadism.
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Affiliation(s)
- Tsukasa Narukawa
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto City, Kyoto, Japan
| | - Jintetsu Soh
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto City, Kyoto, Japan
| | - Noriyuki Kanemitsu
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto City, Kyoto, Japan
| | - Shunji Harikai
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto City, Kyoto, Japan
| | - Atsuko Fujihara
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto City, Kyoto, Japan
| | - Osamu Ukimura
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto City, Kyoto, Japan
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Yafi FA, Sharlip ID, Becher EF. Update on the Safety of Phosphodiesterase Type 5 Inhibitors for the Treatment of Erectile Dysfunction. Sex Med Rev 2017; 6:242-252. [PMID: 28923561 DOI: 10.1016/j.sxmr.2017.08.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 07/31/2017] [Accepted: 08/06/2017] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Phosphodiesterase type 5 inhibitors (PDE5Is) have demonstrated efficacy in the treatment of erectile dysfunction (ED). Although historically found to have limited drug-related adverse events, emerging data have suggested that PDE5Is might be associated with melanoma or recurrence of prostate cancer after radical prostatectomy. AIM To summarize the literature on the safety of PDE5Is. METHODS A literature review was performed through PubMed from 1990 through 2016 regarding ED. Keywords used for the search were erectile dysfunction, phosphodiesterase type 5 inhibitors, sildenafil, vardenafil, tadalafil, avanafil, safety, side effects, and adverse events, among others. MAIN OUTCOME MEASURES Visual, auditory, cardiovascular, renal, hepatic, priapic, and oncologic outcomes associated with the intake of PDE5Is for the treatment of ED, in addition to drug interactions, abuse, overdose, and the phenomenon of counterfeit medications. RESULTS PDE5Is are safe drugs for the management of ED. Although recent studies have shown an increased risk of non-arteritic ischemic optic neuropathy with PDE5Is, the magnitude of that risk is small. The possibility that PDE5Is cause sensorineural hearing loss remains uncertain. PDE5Is display a safe cardiovascular profile if used according to the Princeton III Consensus guidelines. There appears to be an association between PDE5I use and melanoma but the absence of a mechanism of causation raises doubt that the association is cause and effect. PDE5Is do not increase the risk of biochemical recurrence after prostate cancer management. PDE5I abuse and use of counterfeit medications present serious global health concerns. CONCLUSION Current data strongly support the efficacy, tolerability, and overall safety of PDE5Is for the treatment of ED. PDE5Is probably cause a small increase in the risk of non-arteritic ischemic optic neuropathy. Evidence on increased rates of melanoma and prostate cancer recurrence is weak and controversial. PDE5Is should still be considered first-line therapy for the treatment of most etiologies of ED. Yafi FA, Sharlip ID, Becher EF. Update on the Safety of Phosphodiesterase Type 5 Inhibitors for the Treatment of Erectile Dysfunction. Sex Med Rev 2018;6:242-252.
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Affiliation(s)
- Faysal A Yafi
- Department of Urology, University of California, Irvine, CA, USA.
| | - Ira D Sharlip
- Department of Urology, University of California, San Francisco, CA, USA
| | - Edgardo F Becher
- Division of Urology, University of Buenos Aires, Buenos Aires, Argentina
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Pharmacotherapy for Erectile Dysfunction: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015). J Sex Med 2016; 13:465-88. [DOI: 10.1016/j.jsxm.2016.01.016] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/30/2015] [Accepted: 01/06/2016] [Indexed: 02/06/2023]
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Akino H. Editorial Comment to Tadalafil 5 mg once-daily therapy for men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia: Results from a randomized, double-blind, placebo-controlled trial carried out in Japan and Korea. Int J Urol 2014; 21:676. [DOI: 10.1111/iju.12422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Hironobu Akino
- Department of Urology; Faculty of Medical Science; University of Fukui; Fukui Japan
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Tsujimura A, Kiuchi H, Soda T, Takezawa K, Okuda H, Fukuhara S, Takao T, Nonomura N, Miyagawa Y. Sexual life of Japanese patients with erectile dysfunction taking phosphodiesterase type 5 inhibitors: an Internet survey using the Psychological and Interpersonal Relationship Scales-Short Form questionnaire. Int J Urol 2014; 21:821-5. [PMID: 24661267 DOI: 10.1111/iju.12429] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 02/04/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate details of sexual function of erectile dysfunction in Japanese patients taking phosphodiesterase type 5 inhibitors. METHODS A Japanese version of the Psychological and Interpersonal Relationship Scales-Short Form was used to carry out a nationwide survey using the Internet. A total of 556 erectile dysfunction patients (age 30-70 years) who had been prescribed a phosphodiesterase type 5 inhibitor and had attempted sexual intercourse within the past 6 months were included in this survey. Scores were compared in relation to the phosphodiesterase type 5 inhibitors most frequently taken within the past 6 months. RESULTS In the subdomains of self-confidence and spontaneity of the Psychological and Interpersonal Relationship Scales-Short Form, scores for vardenafil and tadalafil were significantly higher than those for sildenafil. In the subdomain of time concern of the Psychological and Interpersonal Relationship Scales-Short Form, the score for tadalafil was significantly lower than that for others. CONCLUSIONS Our findings support the hypothesis that Japanese patients with erectile dysfunction have high sexual self-confidence, spontaneity and low time concerns when taking tadalafil. These characteristics of tadalafil could be associated with high patient satisfaction and high preference.
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Affiliation(s)
- Akira Tsujimura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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Takeda M, Nishizawa O, Imaoka T, Morisaki Y, Viktrup L. Tadalafil for the Treatment of Lower Urinary Tract Symptoms in Japanese Men with Benign Prostatic Hyperplasia: Results from a 12-week Placebo-controlled Dose-finding Study with a 42-week Open-label Extension. Low Urin Tract Symptoms 2012; 4:110-9. [PMID: 26676616 DOI: 10.1111/j.1757-5672.2012.00144.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine the efficacy, safety, and dose response of tadalafil once daily in Japanese men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH-LUTS). METHODS Men ≥45 years with moderate-to-severe BPH-LUTS were randomized to once-daily placebo (N = 140), tadalafil 2.5 mg (N = 142), or tadalafil 5.0 mg (N = 140), in a 12-week double-blind phase, followed by a 42-week, tadalafil 5.0 mg open-label extension (OLE) phase (N = 394). The primary outcome was total International Prostate Symptom Score (IPSS) change from baseline to last available observation in the double-blind phase. RESULTS The least squares (LS) mean difference between placebo and tadalafil in total IPSS change from baseline was -0.7 (P = 0.201) and -1.1 (P = 0.062) for tadalafil 2.5 and 5 mg, respectively (ANCOVA; a dose-dependent improvement in placebo-adjusted total IPSS for tadalafil 5 mg versus 2.5 mg of 57%). Repeated-measures analyses identified a significant total IPSS change for tadalafil 5 mg (LS mean difference between placebo and tadalafil 5 mg: -1.2; P = 0.035), but not tadalafil 2.5 mg, at week 12. Significant improvements for tadalafil 5 mg were demonstrated (ANCOVA) for IPSS obstructive subscore (P = 0.033) and IPSS quality of life index (P = 0.022). Numerical improvements in IPSS scores were maintained over the OLE phase. Tadalafil was well tolerated with no unexpected adverse events. CONCLUSION Tadalafil (5.0 mg) had a favorable benefit-to-risk profile, supporting further investigation of tadalafil (5.0 mg) in Japanese men with BPH-LUTS.
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Affiliation(s)
- Masayuki Takeda
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, JapanDepartment of Urology, Shinshu University School of Medicine, Matsumoto, JapanLilly Research Laboratories Japan, Eli Lilly Japan K.K., Kobe, JapanLilly Research Laboratories, Eli Lilly and Co., Indianapolis, USA
| | - Osamu Nishizawa
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, JapanDepartment of Urology, Shinshu University School of Medicine, Matsumoto, JapanLilly Research Laboratories Japan, Eli Lilly Japan K.K., Kobe, JapanLilly Research Laboratories, Eli Lilly and Co., Indianapolis, USA
| | - Takeshi Imaoka
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, JapanDepartment of Urology, Shinshu University School of Medicine, Matsumoto, JapanLilly Research Laboratories Japan, Eli Lilly Japan K.K., Kobe, JapanLilly Research Laboratories, Eli Lilly and Co., Indianapolis, USA
| | - Yoji Morisaki
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, JapanDepartment of Urology, Shinshu University School of Medicine, Matsumoto, JapanLilly Research Laboratories Japan, Eli Lilly Japan K.K., Kobe, JapanLilly Research Laboratories, Eli Lilly and Co., Indianapolis, USA
| | - Lars Viktrup
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, JapanDepartment of Urology, Shinshu University School of Medicine, Matsumoto, JapanLilly Research Laboratories Japan, Eli Lilly Japan K.K., Kobe, JapanLilly Research Laboratories, Eli Lilly and Co., Indianapolis, USA
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Bénard F, Carrier S, Lee JC, Talwar V, Defoy I. Men with Mild Erectile Dysfunction Benefit from Sildenafil Treatment. J Sex Med 2010; 7:3725-35. [DOI: 10.1111/j.1743-6109.2010.02015.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Lee JC, Bénard F, Carrier S, Talwar V, Defoy I. Do men with mild erectile dysfunction have the same risk factors as the general erectile dysfunction clinical trial population? BJU Int 2010; 107:956-60. [PMID: 20950304 DOI: 10.1111/j.1464-410x.2010.09691.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE • To compare the underlying risk for diseases associated with erectile dysfunction (ED; i.e. cardiovascular disease and diabetes) in a population of men with mild ED relative to a general ED clinical trial population. PATIENTS AND METHODS • Men enrolled in a randomized, double-blind placebo-controlled (DBPC) trial of sildenafil for the treatment of mild ED were compared with a database of men enrolled in 67 of the manufacturer's other DBPC sildenafil trials. • The main outcome measures were baseline demographics, comorbidities and concomitant medications. RESULTS • In both populations, most men were white, approximately one quarter were smokers, and most had an organic component to their ED etiology. • In the mild ED population (N = 176) versus the database population (N = 14,537), mean ± sd (range) age was 50 ± 12 (19-84) versus 55 ± 11 (18-89) years, body mass index was 29 ± 5 (20-48) versus 28 ± 5 (11-64) kg/m² and ED duration was 3.5 ± 3.2 (< 1-18) versus 4.6 ± 4.7 (< 1-45) years. • The prevalence of comorbidities associated with ED was similar (hypertension 26.1% (n = 46) vs 32.8%; diabetes mellitus 13.6% (n = 24) vs 22.1%; dyslipidemias 12.5% (n = 22) vs 11.7%; hypercholesterolemia 12.5% (n = 22) vs 9.5%; gastro-esophageal reflux disease 10.8% (n = 19) vs 6.0%; benign prostatic hyperplasia 9.7% (n = 17) vs 9.9%; depression 6.3% (n = 11) vs 5.6%; and anxiety 4.0% (n = 7) vs 1.6%), as was the rate of use of medications for those comorbidities. CONCLUSIONS • Men with mild ED have similar risk factors to a general ED clinical trial population. Thus, mild ED is an important indicator of risk for underlying disease associated with ED. • Inquiry into ED should be part of routine clinical evaluation to facilitate rapid identification and early intervention. • Men complaining of mild ED should be evaluated adequately for underlying cardiovascular risk.
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Affiliation(s)
- Jay C Lee
- Rockyview Hospital, Calgary, QC, Canada.
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Eardley I, Donatucci C, Corbin J, El-Meliegy A, Hatzimouratidis K, McVary K, Munarriz R, Lee SW. Pharmacotherapy for Erectile Dysfunction. J Sex Med 2010; 7:524-40. [DOI: 10.1111/j.1743-6109.2009.01627.x] [Citation(s) in RCA: 140] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Guo YL, Viswanathan VP, Chiang HS, Choi HK, Yip AWC, Shen W, Kopernicky V. Efficacy and safety of tadalafil taken as needed for the treatment of erectile dysfunction in Asian men: results of an integrated analysis. Asian J Androl 2009; 11:423-33. [PMID: 19377488 DOI: 10.1038/aja.2009.11] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We evaluated the efficacy and safety of as-needed tadalafil in a diverse clinical population (with varying patient demographics, disease severity, and comorbid medical conditions) of Asian men with erectile dysfunction (ED). An integrated analysis of five double-blind, placebo-controlled trials (N = 1 046) was performed. Patients were randomly assigned to receive 10 mg tadalafil (N = 185), 20 mg tadalafil (N = 510), or placebo (N = 351). Efficacy assessments included the International Index of Erectile Function (IIEF), Sexual Encounter Profile (SEP) diary and Global Assessment Question (GAQ). Patients receiving 10 mg or 20 mg tadalafil showed significant improvement from baseline-to-end point on the Erectile Function domain of the International Index of Erectile Function (IIEF-EF) domain score in all clinical sub-populations analyzed, compared with patients receiving placebo (P < 0.001). The 10-mg and 20-mg tadalafil groups showed a mean success rate of 64.1% and 70.5% for sexual intercourse attempts (SEP3, successful intercourse), respectively, compared with 33.4% in the placebo group (P < 0.001), and 85.5% and 85.4% reported improved erections at end point GAQ, respectively, versus 43.5% in the placebo group (P < 0.001). Tadalafil was well tolerated across all groups studied. Headache and back pain were the most frequently reported adverse events. Overall, tadalafil was effective and well tolerated across a diverse clinical spectrum of Asian men with ED.
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Affiliation(s)
- Ying-Lu Guo
- Andrology Center, Peking University First Hospital, Peking University, Beijing 100009, China
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[Comparative study for the treatment of erectile dysfunction with sildenafil and vardenafil--multi-centric research in Nagano City]. Nihon Hinyokika Gakkai Zasshi 2009; 100:1-6. [PMID: 19198222 DOI: 10.5980/jpnjurol.100.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The efficacy and safety of two types of phoshodiestrase type 5 ( PDE 5) inhibitors (sildenafil (sil) and vardenafil (var)) were investigated for multi-centric study. SUBJECTS AND METHODS One hundred and twenty five patients (55.9 +/- 10.9 years old) with erectile dysfunction (ED) were treated by both of sil and var. The patients were administered a pair of 25 mg of sil and 5 mg of var, or 50 mg of sil and 10 mg of var. The efficacy for ED and safety of these 2 drugs were evaluated after administration of each drugs at least 2 times. RESULTS The results showed that the score of international index of erectile function 5 (IIEF5) were elevated from 8.87 +/- 4.10 to 17.24 +/- 6.17 after treatments (p< 0.0001, Student' s t test). The efficacy rates for ED were 81.6% in sil and 81.6% in var, respectively. The adverse reactions rates such as headache, burning, palpitation, etc. were 13.6% in sil and 5.6% in var, which is significantly higher in sil (p = 0.032; chi2 test). These side effects were not serious at all, and there were no cases that gave up to use PDE5 inhibitors because of adverse reactions. According to individual patients experiences, 40.7% of patients preferred sil, 45.4% choose var. In addition, associated effects for quality of life (QOL) of ED patients treated by PDE5 inhibitors were analyzed. The results revealed that encouraging in life 46.5%, rejuvenation feeling 45.1%, self care for their health 28.2%, improvement of depression 12.7%, improvement of voiding dysfunction 5.6%, intimacy with partner 38.0%, good conversation with partner 18.3%, and so on. CONCLUSION The treatments of ED by sil and var were very effective and safety. Furthermore, associated effects for QOL of ED patients were also improved with these treatments.
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Yamaguchi T, Uenaka K, Imaoka T. [Pharmacological, pharmacokinetic, and clinical profile of tadalafil (Cialis)]. Nihon Yakurigaku Zasshi 2008; 131:469-77. [PMID: 18552451 DOI: 10.1254/fpj.131.469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kimoto Y, Nagao K, Sasaki H, Marumo K, Takahashi Y, Nishi S, Ishikura F, Futamatsu M. JSSM Guidelines for erectile dysfunction. Int J Urol 2008; 15:564-76. [DOI: 10.1111/j.1442-2042.2008.02060.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2007. [DOI: 10.1002/pds.1375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Marumo K, Imaoka T, Fujimoto K, Watts S, Stothard D, McGill J. ORIGINAL RESEARCH—ED PHARMACOTHERAPY: A Comparison of the Efficacy and Tolerability of Tadalafil 10 mg and 20 mg in Japanese Patients with Severe Erectile Dysfunction. J Sex Med 2007; 4:745-752. [PMID: 17087800 DOI: 10.1111/j.1743-6109.2006.00387.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Tadalafil is a phosphodiesterase type 5 inhibitor with documented efficacy in the treatment of erectile dysfunction (ED). AIM To compare the efficacy and tolerability of tadalafil 10 mg and 20 mg in men with severe ED. METHODS A prespecified subgroup analysis was conducted to compare the efficacy of tadalafil 10 and 20 mg measured by the International Index of Erectile Function (IIEF) erectile function (EF) domain and Sexual Encounter Profile (SEP) among patients with severe ED (EF domain score = 1-10) in a Japanese placebo-controlled study (PCT). We also analyzed the efficacy of the two doses in men with severe ED post hoc by pooling data from three tadalafil clinical trials that evaluated these doses using a similar study design (three placebo-controlled trials), and evaluated (post hoc) the presence of organic comorbidities in patients with different levels of response to tadalafil 10 or 20 mg. MAIN OUTCOME MEASURES Mean change in the IIEF-EF domain and mean per-patient changes in percent "yes" responses to SEP Question 2 (SEP2) and Question 3 (SEP3). RESULTS Patients with severe ED in the Japanese study experienced numerically greater increases (improvements) when taking tadalafil 20 mg compared with 10 mg in the IIEF-EF domain (14.3 vs. 12.4; P = 0.355), SEP2 (60% vs. 57%; P = 0.781), and SEP3 (61% vs. 49%, P = 0.196). When sufficiently powered, these observations reached statistical significance in the three PCTs: patients with severe ED experienced greater increases when taking tadalafil 20 mg compared with 10 mg in the IIEF-EF domain (13.6 vs. 10.4; P = 0.014) and SEP3 (56% vs. 43%, P = 0.019). Both doses were well tolerated. CONCLUSIONS Patients with severe ED, and especially those with an organic comorbidity, may derive greater clinical benefits from tadalafil 20 mg compared with 10 mg.
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Affiliation(s)
- Ken Marumo
- Department of Urology, Tokyo Dental College, Ichikawa General Hospital, Chiba
| | | | | | - Steven Watts
- Lilly Research Laboratories, Indianapolis, IN, USA
| | | | - James McGill
- Lilly Research Laboratories, Indianapolis, IN, USA.
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