Tolerance to the Therapeutic Effect of Tadalafil Does Not Occur During 6 Months of Treatment: A Randomized, Double‐Blind, Placebo‐Controlled Study in Men with Erectile Dysfunction

Therapeutic response after first month of tadalafil treatment predicts 12 months treatment continuation in patients with erectile dysfunction: results from the DETECT study

INTRODUCTION

The DETECT study is a prospective, 12-month, European, multicenter, observational study of patients with erectile dysfunction (ED) initiating or changing treatment to tadalafil in routine clinical practice.

AIM

To determine the effectiveness of tadalafil and the factors associated with the continuation of treatment for ED at 12 months.

METHODS

The DETECT study included 1,900 men aged 18 years and older with a history of ED and who were initiating or changing treatment to tadalafil.

MAIN OUTCOME MEASURES

Sexual function at baseline, 1, 6, and 12 months was assessed using the International Index of Erectile Function-erectile function (IIEF-EF) domain. Factors associated with treatment continuation at 12 months were evaluated using multivariate regression analysis.

RESULTS

At 12 months, 1,319 (84%) of 1,567 patients who completed the questionnaire reported continued use of tadalafil. Among these patients, tadalafil was highly effective: 94%, 95%, and 71% with severe, moderate, and mild ED at baseline, respectively, improved by at least one IIEF-EF category and 65% had normal EF. Five factors were associated with tadalafil continuation at 12 months: (i) ED severity at 1 month (based on IIEF-EF domain score); (ii) tolerance to treatment at 1 month; (iii) age younger than 60 years; (iv) number of sexual attempts in the first month; and (v) no history of pelvic surgery. Patient and partner factors at baseline were not significantly associated with continued tadalafil use.

CONCLUSIONS

Tadalafil is an effective treatment for ED in routine clinical practice. The therapeutic response and treatment tolerance after 1-month treatment are the most important factors influencing tadalafil continuation.

Tadalafil dosed once a day in men with erectile dysfunction: a randomized, double-blind, placebo-controlled study in the US

The efficacy and safety of tadalafil, dosed once a day for the treatment of erectile dysfunction, was assessed in a randomized, double-blind, placebo-controlled, parallel-design study at 15 US centers. Following a 4-week treatment-free run-in period, patients (>or=18 years of age) were randomly assigned to 24 weeks treatment with tadalafil 2.5 mg, tadalafil 5 mg or placebo. Primary efficacy endpoints were change at 24 weeks in International Index of Erectile Function Erectile Function (EF) Domain score and mean per-patient percentage 'yes' responses to Sexual Encounter Profile diary questions 2 and 3. Tadalafil significantly improved erectile function compared with placebo for all three co-primary efficacy endpoints. Few patients discontinued because of adverse events (2.1%, placebo; 6.3%, tadalafil 2.5 mg; 4.1%, tadalafil 5 mg). Common treatment-emergent adverse events (>or=5%) were nasopharyngitis, influenza, viral gastroenteritis and back pain. Tadalafil 2.5 mg and 5 mg, dosed once a day for 24 weeks, was well tolerated and significantly improved erectile function.