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Kim M, Noh Y, Yamada A, Hong SH. Comparison of the Erectile Dysfunction Drugs Sildenafil and Tadalafil Using Patient Medication Reviews: Topic Modeling Study. JMIR Med Inform 2022; 10:e32689. [PMID: 35225813 PMCID: PMC8922152 DOI: 10.2196/32689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/22/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Topic modeling of patient medication reviews of erectile dysfunction (ED) drugs can help identify patient preferences regarding ED treatment options. The identification of a set of topics important to the patient from social network service drug reviews would inform the design of patient-centered medication counseling. OBJECTIVE This study aimed to (1) identify the distinctive topics from patient medication reviews unique to tadalafil versus sildenafil; (2) determine if the primary topics are distributed differently for each drug and for each patient characteristic (age and time on ED drug therapy); and (3) test if the primary topics affect satisfaction with ED drug therapy controlling for patient characteristics. METHODS Data were collected from the patient medication reviews of sildenafil and tadalafil posted on WebMD and Ask a Patient. The latent Dirichlet allocation method of natural language processing was used to identify 5 distinctive topics from the patient medication reviews on each drug. Analysis of variance and a 2-sample t test were conducted to compare the topic distribution and assess whether patient satisfaction varies with the primary topics, age, and time on medication for each ED drug. Statistical significance was tested at an alpha of .05. RESULTS The patient medication reviews of sildenafil (N=463) had 2 topics on treatment benefit and 1 each on medication safety, marketing claim, and treatment comparison, while the patient medication reviews of tadalafil (N=919) had 2 topics on medication safety and 1 each on the remaining subjects. Sildenafil's reviewers quite frequently (94/463, 20.4%) mentioned erection sustainability as their primary topic, whereas tadalafil's reviewers were more concerned about severe medication safety. Those who mentioned erection sustainability as their primary topic were quite satisfied with their treatment as opposed to those who mentioned severe medication safety as their primary topic (score 3.85 vs 2.44). The discovered topics reflected the marketing claims of blue magic and amber romance for sildenafil and tadalafil, respectively. The topic of blue magic was preferred among younger patients, while the topic of amber romance was preferred among older patients. The topic alternative choices, which appeared for both the ED drugs, reflected patient interest in the comparative effectiveness and price outside the drug labeling information. CONCLUSIONS The patient medication reviews of ED drugs reflect patient preferences regarding drug labeling information, marketing claims, and alternative treatment choices. The patient preferences concerning ED treatment attributes inform the design of patient-centered communication for improved ED drug therapy.
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Affiliation(s)
- Maryanne Kim
- College of Pharmacy, Seoul National University, Seoul, Republic of Korea.,Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
| | - Youran Noh
- College of Pharmacy, Seoul National University, Seoul, Republic of Korea.,Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
| | - Akihiko Yamada
- College of Pharmacy, Seoul National University, Seoul, Republic of Korea
| | - Song Hee Hong
- College of Pharmacy, Seoul National University, Seoul, Republic of Korea.,Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
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2
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Domes T, Najafabadi BT, Roberts M, Campbell J, Flannigan R, Bach P, Patel P, Langille G, Krakowsky Y, Violette PD. AUTHOR REPLY: The nuances of GRADE. Can Urol Assoc J 2021; 15:426-428. [PMID: 34847349 DOI: 10.5489/cuaj.7679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Trustin Domes
- Division of Urology, Department of Surgery, University of Saskatchewan, Saskatoon, SK, Canada
| | - Borna Tadayon Najafabadi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Matthew Roberts
- Division of Urology, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
| | - Jeffrey Campbell
- Division of Urology, Department of Surgery, Western University, London, ON, Canada
| | - Ryan Flannigan
- Department of Urological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Phil Bach
- Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Premal Patel
- Division of Urology, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada
| | | | - Yonah Krakowsky
- Division of Urology, Women's College Hospital & Sinai Health System, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Philippe D Violette
- Department of Surgery, McMaster University, Hamilton, ON, Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
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Domes T, Najafabadi BT, Roberts M, Campbell J, Flannigan R, Bach P, Patel P, Langille G, Krakowsky Y, Violette PD, Brock GB, Yafi FA. Canadian Urological Association guideline: Erectile dysfunction. Can Urol Assoc J 2021; 15:310-322. [PMID: 34665713 DOI: 10.5489/cuaj.7572] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Erectile dysfunction (ED) impacts the wellness and quality of life of millions of Canadians. An evaluation focused on the identification of reversible and irreversible underlying factors is recommended for patients presenting with ED. Through a shared decision-making model framework, the goal of ED treatment is to improve functional outcomes and enhance sexual satisfaction while minimizing adverse effects associated with treatment. Given that ED is assessed and treated by multiple different types of health practitioners, the purpose of this guideline is to provide the best available evidence to facilitate care delivery through a Canadian lens. After a narrative review of ED assessment and treatment for general readership, five key clinical questions relating to priority areas of ED are assessed using the GRADE and evidence-to-decision-making frameworks.
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Affiliation(s)
- Trustin Domes
- Division of Urology, Department of Surgery, University of Saskatchewan, Saskatoon, SK, Canada
| | - Borna Tadayon Najafabadi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Matthew Roberts
- Division of Urology, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
| | - Jeffrey Campbell
- Division of Urology, Department of Surgery, Western University, London, ON, Canada
| | - Ryan Flannigan
- Department of Urological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Phil Bach
- Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Premal Patel
- Division of Urology, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada
| | | | - Yonah Krakowsky
- Division of Urology, Women's College Hospital & Sinai Health System, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Philippe D Violette
- Department of Surgery, McMaster University, Hamilton, ON, Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Gerald B Brock
- Professor Emeritus, Western University, London, ON, Canada
| | - Faysal A Yafi
- Department of Urology, University of California Irvine, Irvine, CA, United States
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4
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Zhou Z, Chen H, Wu J, Wang J, Zhang X, Ma J, Cui Y. Meta-Analysis of the Long-Term Efficacy and Tolerance of Tadalafil Daily Compared With Tadalafil On-Demand in Treating Men With Erectile Dysfunction. Sex Med 2019; 7:282-291. [PMID: 31307951 PMCID: PMC6728809 DOI: 10.1016/j.esxm.2019.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/10/2019] [Accepted: 06/17/2019] [Indexed: 12/04/2022] Open
Abstract
Background Erectile dysfunction (ED) is highly prevalent in aging men. Tadalafil daily and on-demand are widely used for the treatment of ED. Aim We performed a meta-analysis to evaluate the efficacy and safety of tadalafil daily compared with tadalafil on-demand in treating men with ED after at least 24 weeks of long-term treatment. Methods Randomized controlled trials of tadalafil daily vs on-demand in treating men with ED were searched using MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. Systematic review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-analyses. The data was calculated by RevMan version 5.3.0. The references of related articles were also searched. Outcomes International Index of Erectile Function-Erectile Function domain, sexual encounter profile question 2 (SEP2), SEP question 3 (SEP3), any treatment-emergent adverse event (AE), discontinuation due to AEs, myalgia, back pain, headache, dyspepsia, and nasopharyngitis. Results 4 articles, including 1,035 participants were studied. The analysis found that tadalafil daily had a greater improvement than tadalafil on-demand in terms of International Index of Erectile Function-Erectile Function (mean difference (MD) 1.24; 95% CI 0.03−2.44; P = .04), SEP2 (MD 10.08; 95% CI 9.15−11.01; P < .00001) and SEP3 (MD 8.19; 95% CI 2.09−14.29; P = .009) in treating ED after at least 24 weeks treatment cycle. For safety, tadalafil on-demand had a higher incidence of any treatment-emergent AE (odds ratio 0.73; 95% CI 0.56−0.96; P = .02) compared with tadalafil daily, but for other aspects, including discontinuation due to AEs, myalgia, back pain, headache, dyspepsia, and nasopharyngitis, there were no significant difference between the 2 treatments. Clinical Implications Tadalafil daily may offer a better effect for ED than on-demand for long-term treatment. Strengths and Limitations From the perspective of evidence-based medicine, we evaluated the efficacy and safety of tadalafil daily compared with tadalafil on-demand in treating men with ED after a long-term treatment. The quality of these studies included is flawed, primarily in difference in tadalafil doses and severity of the ED. Conclusion Tadalafil daily provides a preferable therapeutic effect for ED with a lower incidence of treatment-emergent side effects relative to tadalafil on-demand after at least 24 weeks of long-term treatment. Zhou Z, Chen H, Wu J, et al. Meta-Analysis of the Long-Term Efficacy and Tolerance of Tadalafil Daily Compared With Tadalafil On-Demand in Treating Men With Erectile Dysfunction. J Sex Med 2019;7:282–291.
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Affiliation(s)
- Zhongbao Zhou
- Binzhou Medical University, Yantai, Shandong, China; Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Hongyan Chen
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Jitao Wu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Jipeng Wang
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Xuebao Zhang
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Jiajia Ma
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Yuanshan Cui
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China.
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5
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Lee M, Sharifi R. Non-invasive Management Options for Erectile Dysfunction When a Phosphodiesterase Type 5 Inhibitor Fails. Drugs Aging 2018; 35:175-187. [PMID: 29464656 DOI: 10.1007/s40266-018-0528-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Phosphodiesterase type 5 inhibitors (PDE5Is) are the drug of choice for medical management of erectile dysfunction (ED). On-demand PDE5Is have an overall efficacy of 60-70% for ED; 30-35% of patients fail to respond to a PDE5I, and 30-50% of non-responders can be salvaged with detailed counseling on proper use and physician follow-up to ensure that the patient has been prescribed an appropriate and full PDE5I clinical trial. True non-responders may be offered intracavernosal injections of erectogenic drugs, intraurethral alprostadil, or surgical insertion of a penile prosthesis. Such options are not discreet and are associated with more adverse effects than PDE5Is. Thus patients may request additional non-invasive medical management options. This review describes published literature on patients who failed to respond to an on-demand PDE5I regimen and were treated with a non-invasive PDEI-based regimen, including switching from one PDE5I to another; increasing the dose of PDE5I above the labeled dosage range; using two PDE5Is concurrently; using a daily PDE5I regimen; or combining a PDE5I with a testosterone supplement, α-adrenergic antagonist, intraurethral or intracavernosal alprostadil, vacuum erection device, or low-intensity shock wave therapy. The limitations of published clinical trials do not allow for sufficient evidence to recommend one option over another. Therefore, in PDE5I-refractory patients, the choice of a specific next step should be individualized based on the preference of the patient and his sexual partner, the advantages and disadvantages of the various options, the concurrent medical illnesses and medications of the patient, and the patient's response to treatment.
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Affiliation(s)
- Mary Lee
- Pharmacy Practice, Pharmacy and Optometry Education, Midwestern University Chicago College of Pharmacy, Midwestern University, 555 31st Street, Downers Grove, IL, 60515, USA.
| | - Roohollah Sharifi
- Surgery and Urology, Jesse Brown Veterans Administration Medical Center, University of Illinois at Chicago College of Medicine, Chicago, IL, USA
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6
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Bai WJ, Li HJ, Jin JJ, Xu WP, Sebastian S, Wang XF. A randomized clinical trial investigating treatment choice in Chinese men receiving sildenafil citrate and tadalafil for treating erectile dysfunction. Asian J Androl 2018; 19:500-504. [PMID: 27101805 PMCID: PMC5507101 DOI: 10.4103/1008-682x.175782] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Sildenafil and tadalafil are efficacious and well tolerated in Chinese men with erectile dysfunction (ED). Recent study results indicate that men with ED in China who were naïve to phosphodiesterase inhibitor type 5 (PDE5) therapy prefer tadalafil 20-mg (on-demand) versus sildenafil 100-mg (on-demand). Differences in psychosocial outcomes may help to explain treatment preference in favor of tadalafil. This open-label, randomized, crossover study compared psychosocial outcomes and drug attribute choices between tadalafil and sildenafil in Chinese men with ED naïve to PDE5 inhibitor therapy. Eligible patients were randomized to sequential 20-mg tadalafil/100-mg sildenafil (n = 190) or 100-mg sildenafil/20-mg tadalafil (n = 193) for 8 weeks each and were asked which treatment they preferred to take for the 8-week extension phase. Psychosocial outcomes were assessed using the Psychological and Interpersonal Relationship Scale (PAIRS), Drug Attributes Questionnaire (DRAQ), and Sexual Life Quality Questionnaire (SLQQ). When taking tadalafil versus sildenafil, men had a higher mean endpoint score on the PAIRS Spontaneity Domain (tadalafil = 2.86 vs sildenafil = 2.72; P < 0.001), and a lower mean endpoint score on the Time Concerns Domain (tadalafil = 2.41 vs sildenafil = 2.55; P < 0.001). A numerical increase in the Sexual Self-Confidence Domain was observed when taking tadalafil versus sildenafil (tadalafil = 2.76 vs sildenafil = 2.72; P = 0.102). The most frequently chosen drug attributes explaining treatment preference were able to get an erection long after having drug, and ability to get an erection every time. SLQQ results were comparable between treatment groups. These psychosocial outcomes may explain why more Chinese men preferred tadalafil versus sildenafil for the treatment of ED in this clinical trial.
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Affiliation(s)
- Wen-Jun Bai
- Department of Urology, Peking University People's Hospital, Beijing 100044, China
| | - Hong-Jun Li
- Department of Urology, Peking Union Medical College Hospital, Beijing 100730, China
| | - Jian-Jun Jin
- Department of Medical, Lilly Suzhou Pharmaceutical Co., Ltd., Shanghai 200021, China
| | - Wen-Ping Xu
- Department of Medical, Lilly Suzhou Pharmaceutical Co., Ltd., Shanghai 200021, China
| | | | - Xiao-Feng Wang
- Department of Urology, Peking University People's Hospital, Beijing 100044, China
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7
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The Efficacy of Tadalafil Daily vs on Demand in the Treatment of Erectile Dysfunction: A Systematic Review and Meta-analysis. Urology 2017; 112:6-11. [PMID: 28882778 DOI: 10.1016/j.urology.2017.08.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 08/12/2017] [Accepted: 08/18/2017] [Indexed: 11/23/2022]
Abstract
We present a review comparing the use of tadalafil daily vs on-demand for erectile dysfunction. We examined randomized controlled trials and observational studies that examined the use of tadalafil for at least 8 weeks of follow-up with the primary outcome of International Index for Erectile Dysfunction-Erectile Function domain. Eight studies that examined the desired dosing regimens were identified. Of these, 6 studies included the primary end point of 12 weeks. Those patients taking tadalafil daily for 12 weeks scored on average 1.82 points higher in International Index for Erectile Dysfunction-Erectile Function domain scores, although the difference may not be clinically significant (Fig. 1).
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8
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Gong B, Ma M, Xie W, Yang X, Huang Y, Sun T, Luo Y, Huang J. Direct comparison of tadalafil with sildenafil for the treatment of erectile dysfunction: a systematic review and meta-analysis. Int Urol Nephrol 2017; 49:1731-1740. [PMID: 28741090 PMCID: PMC5603624 DOI: 10.1007/s11255-017-1644-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 06/26/2017] [Indexed: 12/17/2022]
Abstract
Aims Erectile dysfunction (ED) is a major care problem worldwide. Tadalafil and sildenafil are the two most common phosphodiesterase 5 inhibitors used to treat ED. This systematic review and meta-analysis were conducted to directly compare tadalafil with sildenafil for the treatment of ED. Methods We designed a strategy for searching the PubMed, Embase, EBSCO, Web of Science and Cochrane library databases; the reference lists of the retrieved studies were also investigated. A literature review was performed to identify all published randomized or non-randomized controlled trials that compared tadalafil with sildenafil for the treatment of ED and to assess the quality of the studies. Two investigators independently and blindly screened the studies for inclusion. The meta-analysis was performed using RevMan 5.0. Results A total of 16 trials that compared tadalafil with sildenafil for the treatment of ED were included in the meta-analysis. In the meta-analysis, tadalafil and sildenafil appeared to have similar efficacies and overall adverse event rates. However, compared with sildenafil, tadalafil significantly improved psychological outcomes. Furthermore, the patients and their partners preferred tadalafil over sildenafil, and no significant difference was found in the adherence and persistence rates between tadalafil and sildenafil. Additionally, the myalgia and back pain rates were higher and the flushing rate was lower with tadalafil than with sildenafil. Conclusion Tadalafil shares a similar efficacy and safety with sildenafil and significantly improves patients’ sexual confidence. Furthermore, patients and their partners prefer tadalafil to sildenafil. Hence, tadalafil may be a better choice for ED treatment.
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Affiliation(s)
- Binbin Gong
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China
| | - Ming Ma
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China.
| | - Wenjie Xie
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China
| | - Xiaorong Yang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China
| | - Yongming Huang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China
| | - Ting Sun
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China.
| | - Yanping Luo
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China
| | - Jiao Huang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China
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9
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Li HJ, Bai WJ, Dai YT, Xu WP, Wang CN, Li HZ. An analysis of treatment preferences and sexual quality of life outcomes in female partners of Chinese men with erectile dysfunction. Asian J Androl 2017; 18:773-9. [PMID: 26459780 PMCID: PMC5000803 DOI: 10.4103/1008-682x.159719] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The impact of erectile dysfunction is distressing to both males and their female partners, but less attention has been paid to identify female partners' preferred treatment and sexual quality of life outcomes. The present analysis explores female partners' treatment preference for erectile dysfunction in Chinese Men. This was a phase 4, randomized, open-label, multicenter, crossover study in Chinese men with erectile dysfunction who were naïve to phosphodiesterase type 5 inhibitor treatments. Eligible patients were randomized to sequential 20-mg tadalafil/100-mg sildenafil or 100-mg sildenafil/20-mg tadalafil for 8 weeks each. Of 418 patients, female partners of 64 patients agreed to enter the study; of 64 patients who entered the study with female partners, 63 were randomized, and 62 completed the study. Baseline demographics and disease characteristics were comparable between treatment groups. Significantly more couples preferred tadalafil compared with sildenafil overall (75.4% vs 24.6%; P < 0.001), and irrespective of erectile dysfunction severity at baseline (P ≤ 0.005). Significant improvements in sexual quality of life scores were reported at endpoint (Visit 8) in male patients and female partners in both tadalafil and sildenafil treatment groups (P < 0.001). Significantly higher mean changes from baseline were observed for male patients in the tadalafil group compared with the sildenafil group for the erectile function (P = 0.013) and overall satisfaction (P = 0.019) International Index for Erectile Function domains and the spontaneity domain (P < 0.001) of the Psychological and Interpersonal Relationship Scale. No major safety concerns were reported during the study. Though both treatments were effective, safe, and tolerable, more couples preferred tadalafil compared with sildenafil.
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Affiliation(s)
- Hong-Jun Li
- Department of Urology, Peking Union Medical College Hospital, Beijing 100730, China
| | - Wen-Jun Bai
- Department of Urology, Peking University People's Hospital, Beijing 100044, China
| | - Yu-Tian Dai
- Department of Andrology, Nanjing Drum Tower Hospital, Jiangsu 210008, China
| | - Wen-Ping Xu
- Department of Medical, Lilly Suzhou Pharmaceutical Co., Ltd., Shanghai 200021, China
| | - Chia-Ning Wang
- Department of Medical, Lilly Suzhou Pharmaceutical Co., Ltd., Shanghai 200021, China
| | - Han-Zhong Li
- Department of Urology, Peking Union Medical College Hospital, Beijing 100730, China
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10
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Sexual Dysfunction in Type 2 Diabetes at Diagnosis: Progression over Time and Drug and Non-Drug Correlated Factors. PLoS One 2016; 11:e0157915. [PMID: 27706160 PMCID: PMC5051725 DOI: 10.1371/journal.pone.0157915] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 06/07/2016] [Indexed: 01/10/2023] Open
Abstract
Aims To present the longitudinal data of the SUBITO-DE study, a prospective survey involving male patients with new or recently diagnosed type 2 diabetes mellitus (T2DM) (<24 months). Materials and Methods Sexual function was assessed in male patients with T2DM at baseline (phase 1) and after a mean follow-up of 18 months (phase 2). Standard metabolic parameters and sexual and depressive symptoms were evaluated. Results Six of the 499 enrolled patients died of different causes during phase 1. Of the 493 surviving men invited to participate in phase 2, 450 (mean age 59.0±9.0 years) (90.2%) accepted and 43 (8.2%) were lost to follow-up. As compared to baseline, the proportion of the men who reported improvement in erectile dysfunction (ED) at follow-up was nearly double that of the men who reported worsening of ED (22.6% vs. 12.8%). The increase in frequency of sexual activity the men reported at follow-up assessment indicates that many never treated before baseline were taking an ED drug during the study period (106 subjects). Phosphodiesterase type 5 inhibitors (PDE5i) were the ED drugs most commonly taken at both baseline and follow-up. An overall improvement over baseline values was observed in metabolic targets for T2DM and depressive symptoms. Conversely, no change in lifestyle behaviors was recorded during the study. Conclusions Sexual dysfunction is a major concern in men with T2DM. The SUBITO-DE study demonstrates that, when combined with adequate counseling and tailored PDE5i therapy, an integrated approach to achieving metabolic targets in men with T2DM can improve sexual function as well as depressive symptoms.
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Brotto L, Atallah S, Johnson-Agbakwu C, Rosenbaum T, Abdo C, Byers ES, Graham C, Nobre P, Wylie K. Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction. J Sex Med 2016; 13:538-71. [DOI: 10.1016/j.jsxm.2016.01.019] [Citation(s) in RCA: 196] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 01/16/2016] [Accepted: 01/19/2016] [Indexed: 12/11/2022]
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12
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13
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Minkin MJ. Sexual health and relationships after age 60. Maturitas 2016; 83:27-32. [DOI: 10.1016/j.maturitas.2015.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 10/05/2015] [Indexed: 01/09/2023]
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14
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Bai WJ, Li HJ, Dai YT, He XY, Huang YR, Liu JH, Sorsaburu S, Ji C, Jin JJ, Wang XF. An open-label, multicenter, randomized, crossover study comparing sildenafil citrate and tadalafil for treating erectile dysfunction in Chinese men naïve to phosphodiesterase 5 inhibitor therapy. Asian J Androl 2015; 17:61-7. [PMID: 25370206 PMCID: PMC4291880 DOI: 10.4103/1008-682x.143244] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 04/30/2014] [Accepted: 06/12/2014] [Indexed: 12/24/2022] Open
Abstract
The study was to compare treatment preference, efficacy, and tolerability of sildenafil citrate (sildenafil) and tadalafil for treating erectile dysfunction (ED) in Chinese men naοve to phosphodiesterase 5 (PDE5) inhibitor therapies. This multicenter, randomized, open-label, crossover study evaluated whether Chinese men with ED preferred 20-mg tadalafil or 100-mg sildenafil. After a 4 weeks baseline assessment, 383 eligible patients were randomized to sequential 20-mg tadalafil per 100-mg sildenafil or vice versa for 8 weeks respectively and then chose which treatment they preferred to take during the 8 weeks extension. Primary efficacy was measured by Question 1 of the PDE5 Inhibitor Treatment Preference Questionnaire (PITPQ). Secondary efficacy was analyzed by PITPQ Question 2, the International Index of Erectile Function (IIEF) erectile function (EF) domain, sexual encounter profile (SEP) Questions 2 and 3, and the Drug Attributes Questionnaire. Three hundred and fifty men (91%) completed the randomized treatment phase. Two hundred and forty-two per 350 (69.1%) patients preferred 20-mg tadalafil, and 108/350 (30.9%) preferred 100-mg sildenafil (P < 0.001) as their treatment in the 8 weeks extension. Ninety-two per 242 (38%) patients strongly preferred tadalafil and 37/108 (34.3%) strongly the preferred sildenafil. The SEP2 (penetration), SEP3 (successful intercourse), and IIEF-EF domain scores were improved in both tadalafil and sildenafil treatment groups. For patients who preferred tadalafil, getting an erection long after taking the medication was the most reported reason for tadalafil preference. The only treatment-emergent adverse event reported by > 2% of men was headache. After tadalafil and sildenafil treatments, more Chinese men with ED naοve to PDE5 inhibitor preferred tadalafil. Both sildenafil and tadalafil treatments were effective and safe.
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Affiliation(s)
- Wen-Jun Bai
- Department of Urology, People's Hospital of Peking University, Beijing, China
| | - Hong-Jun Li
- Department of Urology, Peking Union Medical College Hospital, Beijing, China
| | - Yu-Tian Dai
- Department of Andrology, Nanjing Drum Tower Hospital, Jiangsu, China
| | - Xue-You He
- Department of Urology, Chinese PLA General Hospital, Beijing, China
| | - Yi-Ran Huang
- Department of Urology, Shanghai Renji Hospital, Shanghai, China
| | - Ji-Hong Liu
- Department of Urology, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | | | - Chen Ji
- Department of Medical, Lilly Suzhou Pharmaceutical Co. Ltd., Shanghai, China
| | - Jian-Jun Jin
- Department of Medical, Lilly Suzhou Pharmaceutical Co. Ltd., Shanghai, China
| | - Xiao-Feng Wang
- Department of Urology, People's Hospital of Peking University, Beijing, China
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Comparative Effectiveness and Safety of Oral Phosphodiesterase Type 5 Inhibitors for Erectile Dysfunction: A Systematic Review and Network Meta-analysis. Eur Urol 2013; 63:902-12. [DOI: 10.1016/j.eururo.2013.01.012] [Citation(s) in RCA: 173] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 01/14/2013] [Indexed: 11/22/2022]
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Boddi V, Corona G, Fisher AD, Mannucci E, Ricca V, Sforza A, Forti G, Maggi M. “It Takes Two to Tango”: The Relational Domain in a Cohort of Subjects with Erectile Dysfunction (ED). J Sex Med 2012; 9:3126-36. [DOI: 10.1111/j.1743-6109.2012.02948.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Conaglen HM, Conaglen JV. Couples' reasons for adherence to, or discontinuation of, PDE type 5 inhibitors for men with erectile dysfunction at 12 to 24-month follow-up after a 6-month free trial. J Sex Med 2012; 9:857-65. [PMID: 22239731 DOI: 10.1111/j.1743-6109.2011.02625.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The history of treatments for erectile dysfunction (ED) has involved a repeated pattern of uptake, followed by abandonment of the various therapies in the medium term. Even effective and simple to use medications are not necessarily continued; discontinuation rates range between 15% and 60%. Despite the association between partner sexual function and men's use of PDE5, no previous studies have reported any contact with partners of men taking PDE5 for their ED. This study involved both partners in couples followed up at least 1 year after treatment of ED. AIM The study sought clarification of factors influencing adherence to, or discontinuation of, oral ED medications from couples. We hypothesized that many factors contribute to decision making about ED medication use at >12 months. MAIN OUTCOME MEASURES The main outcome measures of this article were interviews and International Index of Erectile Function-erectile function domain. METHODS A total of 155 interviews were conducted seeking details of frequency of usage and preference for the drugs available; reasons for that choice, or for discontinuation of use, were also sought. RESULTS Of men interviewed, 71% were using PDE5 at 18 months. Most men interviewed were using the oral medications either 1-2x/week or 1-2x/month. Forty-four percent of men who had decreased their use of the medications reported less need for them. Thirty-four men said the main reason they were using less medication was cost. "Partner issues" from the men's perspective were seldom reported in this study. However, for a number of women, "partner issues" meant a range of problems from separation to alcohol abuse, lack of communication, and lack of confidence, or fear of failure. CONCLUSIONS This is the first study to ask couples why they decided to continue or stop using PDE5 when followed up. Female partners provided a different perspective on "partner issues" often cited as reasons for discontinuing PDE5 use. It was also clear that discontinuation did not mean couples were no longer sexually active.
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Affiliation(s)
- Helen M Conaglen
- Faculty of Medical and Health Sciences, University of Auckland, Hamilton, New Zealand.
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Abstract
The treatment for erectile dysfunction (ED) was revolutionized with the development of phosphodiesterase type 5 (PDE5) inhibitors. Tadalafil (Cialis((R)); Eli Lilly and Company, Indianapolis, IN, USA) is the newest and most versatile PDE5 inhibitor in the clinical armamentarium for the treatment of ED. Its most unique characteristic is its long half-life of 17.5 hours, which lends itself to a longer therapeutic window with on-demand dosing and effective steady-state plasma concentrations with once-daily dosing. Clinical trials have proven its safety and efficacy with both dosing strategies for all severities and etiologies of ED, including difficult-to-treat ED. This thorough review will discuss ED, the physiology of penile erection and the role of PDE5, and all aspects of tadalafil, from its development, through its pharmacology, to its latest clinical studies and indications.
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Affiliation(s)
- Robert M Coward
- Division of Urologic Surgery, University of North Carolina, Chapel Hill, NC, USA.
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Corona G, Mondaini N, Ungar A, Razzoli E, Rossi A, Fusco F. Phosphodiesterase type 5 (PDE5) inhibitors in erectile dysfunction: the proper drug for the proper patient. J Sex Med 2011; 8:3418-32. [PMID: 21995676 DOI: 10.1111/j.1743-6109.2011.02473.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Erectile dysfunction (ED) is a very common multidimensional disorder affecting men worldwide. Physical illness, reaction to life stresses, or an unhappy couple relationship influence clinical outcome. Phosphodiesterase type 5 (PDE5) inhibitors are recognized as efficacious and well tolerated, and are the first-line treatment for ED. Sildenafil, tadalafil, and vardenafil are the most widely used and studied PDE5 inhibitors. Data acquired during a routine diagnostic workup for ED should be taken into account when choosing the best PDE5 inhibitor for the individual patient, creating an individualized treatment plan, and going beyond "experience-based" subjective opinion and unfounded ideas and prejudice regarding currently available drugs. AIM As the process of matching a given patient's profile to any selected PDE5 inhibitor often relies more on physician's personal convictions than on solid evidence, the aim of this review is to identify the main clinical, demographic, and relational factors influencing the choice of the PDE5 inhibitor to be used for the treatment of ED. METHODS A systematic literature search and current treatment guidelines were evaluated in a systematic manner. MAIN OUTCOME MEASURES The main clinical, cultural, and demographical factors to be considered for the treatment of ED have been identified. RESULTS Main factors influencing the choice of the treatment for ED have been described. A short list of items that may help in choosing the right PDE5 inhibitor for the treatment of different patients in daily clinical practice has been prepared. CONCLUSIONS The simple algorithms prepared should be a useful tool to be used in daily practice, which may help in choosing the right treatment for each subject affected by ED.
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Affiliation(s)
- Giovanni Corona
- Andrology and Sexual Medicine Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy
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McCabe MP, O'Connor EJ, Conaglen JV, Conaglen HM. The Impact of Oral ED Medication on Female Partners' Relationship Satisfaction. J Sex Med 2011; 8:479-83. [DOI: 10.1111/j.1743-6109.2010.02094.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Patients’ preference in the treatment of erectile dysfunction: a critical review of the literature. Int J Impot Res 2010; 23:1-8. [DOI: 10.1038/ijir.2010.29] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Conaglen HM, O'Connor EJ, McCabe MP, Conaglen JV. An investigation of sexual dysfunction in female partners of men with erectile dysfunction: how interviews expand on questionnaire responses. Int J Impot Res 2010; 22:355-62. [PMID: 20962793 DOI: 10.1038/ijir.2010.25] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Using the Female Sexual Function Index (FSFI) for investigating female sexual function has become widespread. A score of 26.5 has been suggested as delineating 'functional' from 'dysfunctional' women. This study aimed to understand in greater detail what contributes to changes in women's FSFI scores while their partners are taking oral erectile medications for erection problems. Couples randomized to receive two erectile medications for two 3-month phases, completed questionnaires. FSFI scores were augmented by individual interviews at baseline, 3 and 6 months, in order to better understand what the scores meant in the context of ED medication use. In all, 50% of the women scored <26.5 at baseline; of these 56% recovered by 6 months. A number of 'dysfunctional' women recorded low FSFI scores solely as a result of their partner's ED. Overall, 22% were still 'dysfunctional' at 6 months, but one third of these appeared 'functional' at 3 months. A further group of women continued to record low scores despite reporting much improved sexual satisfaction. The women's interviews elaborate on their FSFI results, with five themes emerging to provide more clarity about the relative changes seen in a prospective study situation, and potentially in clinical practise contexts. The increasing use of questionnaires to determine sexual function should be supplemented with good clinical interviewing. The interview details explain how FSFI fluctuations occurred and contain clinical implications for research and practise in the area of couple's sexuality.
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Affiliation(s)
- H M Conaglen
- Sexual Health Research Unit, Waikato Clinical School, University of Auckland, Hamilton, New Zealand.
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Washington SL, Shindel AW. A once-daily dose of tadalafil for erectile dysfunction: compliance and efficacy. DRUG DESIGN DEVELOPMENT AND THERAPY 2010; 4:159-71. [PMID: 20856843 PMCID: PMC2939761 DOI: 10.2147/dddt.s9067] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Selective phosphodiesterase type 5 inhibitors (PDE5Is) have revolutionized the treatment of erectile dysfunction (ED) in men. As an on-demand treatment, PDE5Is have excellent efficacy and safety in the treatment of ED due to a broad spectrum of etiologies. Nevertheless, these drugs do have side-effect profiles that are troublesome to some patients, eg, headache, dyspepsia, myalgia, etc. Furthermore, many patients and their partners dislike the necessity of on-demand treatment for ED, citing a desire for greater spontaneity with sexual interactions. In 2008, approximately 10 years after the release of the first commercially available PDE5I, a paradigm shift in the management of ED occurred with the approval of once-daily dose of tadalafil by the US Food and Drug Administration for the management of ED. The prolonged half-life of tadalafil lends itself well to this dosing regimen and conveys the advantage of separating medication from sexual interactions; lower dose therapy also carries the theoretical benefit of lower incidence of side effects. In this study, we review the current state of the art with respect to this new management strategy for ED, highlighting published reports of the efficacy and tolerability of the daily dose tadalafil regimen.
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Affiliation(s)
- Samuel L Washington
- School of Medicine, University of California at San Francisco, San Francisco, California, USA
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Althof SE, Rubio-Aurioles E, Kingsberg S, Zeigler H, Wong DG, Burns P. Impact of Tadalafil Once Daily in Men With Erectile Dysfunction—Including a Report of the Partners' Evaluation. Urology 2010; 75:1358-63. [DOI: 10.1016/j.urology.2009.11.066] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Revised: 11/11/2009] [Accepted: 11/14/2009] [Indexed: 11/24/2022]
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Tanner AE, Fortenberry JD, Zimet GD, Reece M, Graham CA, Murray M. Young Women's use of a microbicide surrogate: the complex influence of relationship characteristics and perceived male partners' evaluations. ARCHIVES OF SEXUAL BEHAVIOR 2010; 39:735-747. [PMID: 19224355 DOI: 10.1007/s10508-008-9464-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2007] [Revised: 03/26/2008] [Accepted: 08/16/2008] [Indexed: 05/27/2023]
Abstract
Currently in clinical trials, vaginal microbicides are proposed as a female-initiated method of sexually transmitted infection prevention. Much of microbicide acceptability research has been conducted outside of the United States and frequently without consideration of the social interaction between sex partners, ignoring the complex gender and power structures often inherent in young women's (heterosexual) relationships. Accordingly, the purpose of this study was to build on existing microbicide research by exploring the role of male partners and relationship characteristics on young women's use of a microbicide surrogate, an inert vaginal moisturizer (VM), in a large city in the United States. Individual semi-structured interviews were conducted with 40 young women (18-23 years old; 85% African American; 47.5% mothers) following use of the VM during coital events for a 4 week period. Overall, the results indicated that relationship dynamics and perceptions of male partners influenced VM evaluation. These two factors suggest that relationship context will need to be considered in the promotion of vaginal microbicides. The findings offer insights into how future acceptability and use of microbicides will be influenced by gendered power dynamics. The results also underscore the importance of incorporating men into microbicide promotion efforts while encouraging a dialogue that focuses attention on power inequities that can exist in heterosexual relationships. Detailed understanding of these issues is essential for successful microbicide acceptability, social marketing, education, and use.
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Affiliation(s)
- Amanda E Tanner
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Room 733, Baltimore, MD 21205, USA.
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Park HJ, Park JK, Park K, Min K, Park NC. Efficacy of Udenafil for the Treatment of Erectile Dysfunction up to 12 Hours after Dosing: A Randomized Placebo-Controlled Trial. J Sex Med 2010; 7:2209-2216. [DOI: 10.1111/j.1743-6109.2010.01817.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Corona G, Bandini E, Fisher A, Elisa M, Boddi V, Balercia G, Sforza A, Forti G, Mannucci E, Maggi M. Psychobiological correlates of women's sexual interest as perceived by patients with erectile dysfunction. J Sex Med 2010; 7:2174-2183. [PMID: 20412430 DOI: 10.1111/j.1743-6109.2010.01812.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION We have recently reported that the perceived loss of a partner's sexual desire is independently associated with an increased incidence of major cardiovascular events in patients with erectile dysfunction (ED). No study has ever evaluated the specific impact of men's perception of women's sexual desire on male sexual function and lifestyle attitudes in ED subjects. AIM To evaluate the clinical correlates of the perception of a partner's sexual desire [hypoactive sexual desire (HSD)] in a consecutive series of subjects seeking medical care for ED. METHODS A consecutive series of 2,303 heterosexual male patients (mean age 58.1 ± 10.5) was studied. MAIN OUTCOME MEASURES Patients were interviewed with the Structured Interview on Erectile Dysfunction (SIEDY) structured interview. They also completed the Middlesex Hospital Questionnaire, a brief questionnaire for the screening of the symptoms of mental disorders. RESULTS Among the patients studied, 458 (19.9%) reported a mild loss of their partner's desire, 302 (13.1%) a moderate reduction of libido, while 118 (5.1%) complained of a complete absence of sexual interest on the part of their partner. After adjustment for confounding factors, the perceived women's HSD was associated with different sexual, lifestyle, and relational factors. In particular, more extra-marital affairs, a longer and more hostile couple relationship, as well as a stressful job and both alcohol and smoking abuse were all significantly associated with perceived women's HSD. In addition, the perceived women's moderate to severe HSD was significantly associated with severe ED and less frequent sexual intercourse. Finally, partner HSD was significantly associated with a stepwise increase of free-floating anxiety and depressive symptoms (adj. r = 0.081, P < 0.05 and 0.158, P < 0.0001, respectively). CONCLUSIONS Perceived sexual interest (éros) on the part of the woman can be seen for men not only as a fun and enjoyable behavior, but also a safe strategy for improving a man's overall health and life expectancy.
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Affiliation(s)
- Giovanni Corona
- Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence Italy; Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Elisa Bandini
- Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence Italy
| | - Alessandra Fisher
- Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence Italy
| | - Maseroli Elisa
- Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence Italy
| | - Valentina Boddi
- Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence Italy
| | | | - Alessandra Sforza
- Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Gianni Forti
- Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence Italy
| | - Edoardo Mannucci
- Diabetes Section Geriatric Unit, Department of Critical Care, University of Florence, Florence, Italy
| | - Mario Maggi
- Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence Italy.
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Althof SE, Buvat J, Gutkin SW, Belger M, Stothard DR, Fugl-Meyer AR. Sexual Satisfaction in Men with Erectile Dysfunction: Correlates and Potential Predictors. J Sex Med 2010; 7:203-15. [DOI: 10.1111/j.1743-6109.2009.01554.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Costa P, Grivel T, Gehchan N. Tadalafil once daily in the management of erectile dysfunction: patient and partner perspectives. Patient Prefer Adherence 2009; 3:105-11. [PMID: 19936152 PMCID: PMC2778425 DOI: 10.2147/ppa.s3937] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Erectile dysfunction (ED) is a prevalent condition that affects men and their partners. Significant improvements in the sexual lives of these couples have been achieved with the introduction of phosphodiesterase 5 (PDE5) inhibitors. A PDE5 inhibitor is now widely recognized as the first-line therapy for the majority of men with ED. Currently, three PDE5 inhibitors - sildenafil, tadalafil and vardenafil - are approved to be taken as needed in anticipation of sexual activity, but only one of these, tadalafil, has been approved to be taken once daily. The primary aims of this review are to summarize the patients' and partners' viewpoints of ED management with PDE5 inhibitors, and to determine whether once-daily tadalafil can contribute to improving some psychological aspects of ED (such as sexual self-confidence, spontaneity and time concerns) compared with on-demand tadalafil or other PDE5 inhibitors taken by patients with ED.
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Affiliation(s)
- Pierre Costa
- Service d’Urologie–Andrologie, Hôpital Caremeau, Nîmes, France
- Correspondence: Pierre Costa, Service d’Urologie–Andrologie, Hôpital Caremeau, place du Pr Debré, 30029 Nîmes Cedex 09, France, Tel +33 (0)4 66 68 32 30, Fax +33 (0)4 66 68 37 20, Email
| | | | - Naji Gehchan
- Eli Lilly and Company, Lilly France – Medical Division, Suresnes, France
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Fisher WA, Eardley I, McCabe M, Sand M. Erectile Dysfunction (ED) is a Shared Sexual Concern of Couples II: Association of Female Partner Characteristics with Male Partner ED Treatment Seeking and Phosphodiesterase Type 5 Inhibitor Utilization. J Sex Med 2009; 6:3111-24. [DOI: 10.1111/j.1743-6109.2009.01432.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Verheyden B, Roumeguère T, Bitton A, Belger M, Schmitt H. Effects of 12-month tadalafil therapy for erectile dysfunction on couple relationships: results from the DETECT study. J Sex Med 2009; 6:3458-68. [PMID: 19832933 DOI: 10.1111/j.1743-6109.2009.01527.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Erectile dysfunction (ED) is distressing and can affect a couple's relationship. AIM To investigate partner awareness of ED, relationship problems, and the effects of tadalafil treatment over 12 months. METHODS The Determinants of Continued Use of Tadalafil study is a prospective 12-month European observational study in patients with ED initiating or changing treatment to on-demand tadalafil. A total of 1,900 patients were enrolled in eight countries. Assessments were made on predefined treatment outcomes in a routine clinical setting. MAIN OUTCOME MEASURES At baseline, 1, 6, and 12 months, patients were asked about relationship problems (unspecified), partner awareness and support of consultation, and partner sexual problems. Data were analyzed for patients continuing tadalafil at 12 months. RESULTS At baseline, 96% of patients had a partner, 80% of partners supported an ED consult, and 73% were aware of the consultation. Relationship problems were reported by 17% of patients at baseline. At 12 months, 84% of patients were still taking tadalafil. Of these, 19% reported relationship problems at baseline. After 12 months of treatment with tadalafil, 4% of patients still reported perceived problems. Factors associated with no relationship problems at 12 months were: at baseline, no previous ED treatment, partner in poor health; and at 12 months a lower ED severity. If the partner was felt to have a sexual problem at 12 months, relationship improvement was less likely. Further, 3% of patients developed relationship problems during treatment. Factors associated with developing a relationship problem were: a history of pelvic surgery at baseline, a different partner at 12 months than at baseline, and a partner with a sexual problem at 12 months. CONCLUSIONS Improvement of ED with tadalafil was associated with reduced relationship problems, suggesting that problems were associated with ED and resolved with treatment.
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Affiliation(s)
- Benny Verheyden
- Andrology Unit, Department of Urology, Antwerp University Hospital, Antwerp, Belgium.
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Corona G, Mannucci E, Lotti F, Boddi V, Jannini EA, Fisher AD, Monami M, Sforza A, Forti G, Maggi M. Impairment of Couple Relationship in Male Patients with Sexual Dysfunction is Associated with Overt Hypogonadism. J Sex Med 2009; 6:2591-600. [DOI: 10.1111/j.1743-6109.2009.01352.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Shindel AW. Continuing Medical Education: 2009 Update on Phosphodiesterase Type 5 Inhibitor Therapy Part 2: Updates on Optimal Utilization for Sexual Concerns and Rare Toxicities in This Class (CME). J Sex Med 2009; 6:2352-64; quiz 2365-6. [DOI: 10.1111/j.1743-6109.2009.01447.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Effect of erectile dysfunction medications on coexisting sexual dysfunctions in couples: Partners' Preference Study. SEXUAL AND RELATIONSHIP THERAPY 2009. [DOI: 10.1080/14681990903321775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Fugl-Meyer A, Althof S, Buvat J, Paget MA, Sotomayor M, Stothard D. Aspects of sexual satisfaction in men with erectile dysfunction: a factor analytic and logistic regression approach. J Sex Med 2009; 6:232-42. [PMID: 19170852 DOI: 10.1111/j.1743-6109.2008.01035.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The International Index of Erectile Function (IIEF), Sexual Encounter Profile (SEP), and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) assess efficacy of phosphodiesterase type 5 (PDE5) inhibitor treatment of erectile dysfunction (ED). AIMS To determine the degree that multiplicity of satisfaction questions in ED treatment evaluation instruments are congruent, to better understand the concept of sexual "satisfaction," and to identify factors that correlate with improvement. METHODS Questionnaire data from 4,174 placebo- or tadalafil-treated patients with ED were analyzed. Principal component analysis (PCA) was performed on IIEF and SEP satisfaction questions. Spearman correlation coefficients were determined. Data from 431 of the 4,174 patients who completed EDITS questionnaires were analyzed. Logistic regression was used to investigate improvement of each IIEF satisfaction question. RESULTS PCA rotated on three factors explained 91% of total variance and separated IIEF Q6 (intercourse frequency) from a SEP and a remaining IIEF factor. All correlations between and among questions were close (rho = 0.62-0.98; P < 0.0001), except for those with IIEF Q6 (rho = 0.28-0.34; P < 0.0001). In a sub-sample, PCA of five IIEF, two SEP, and three EDITS questions identified four factors that explained 90% of all variance: EDITS questions, IIEF questions except Q6, SEP questions, and IIEF Q6. Greater improvement in IIEF-EF domain score was consistently and positively associated with satisfaction measures (P < 0.0001). CONCLUSIONS Factor analysis detected close relationships among satisfaction questions in IIEF, SEP, and EDITS instruments, each of which, apart from IIEF Q6 (intercourse frequency), appeared to be an independent measure of satisfaction. Cultural differences may explain different satisfaction correlations with baseline ED severity in different regions. Clinicians may make use of the correlation between intercourse frequency (Q6) and satisfaction when prescribing a PDE5 inhibitor for ED, by explaining that the inhibitor should enable more frequent intercourse.
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Affiliation(s)
- Axel Fugl-Meyer
- University of Uppsala-Neuroscience, Rehabilitation Medicine, Upssala, Sweden.
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Jannini EA, Isidori AM, Gravina GL, Aversa A, Balercia G, Bocchio M, Boscaro M, Carani C, Corona G, Fabbri A, Foresta C, Forti G, Francavilla S, Granata ARM, Maggi M, Mansani R, Palego P, Spera G, Vetri M, Lenzi A. The ENDOTRIAL study: a spontaneous, open-label, randomized, multicenter, crossover study on the efficacy of sildenafil, tadalafil, and vardenafil in the treatment of erectile dysfunction. J Sex Med 2009; 6:2547-60. [PMID: 19570039 DOI: 10.1111/j.1743-6109.2009.01375.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The three effective, commercially available drugs for the treatment of erectile dysfunction-sildenafil, vardenafil, and tadalafil-inhibit the same substrate, the erectolytic enzyme phosphodiesterase type 5 (PDE5). Although there are pharmacological differences between these three compounds, few comparative studies have been conducted to date. AIM The aim of this study was to determine the efficacy of sildenafil, tadalafil, and vardenafil in a randomly assigned 8-week fixed regimen. METHODS This was a spontaneous, open-label, randomized, multicenter, crossover study where the patients were randomized to receive sildenafil 50 mg, sildenafil 100 mg, tadalafil 20 mg, or vardenafil 20 mg. MAIN OUTCOME MEASURES The primary outcome included the posttreatment analysis of erectile function domains of the abridged International Index of Erectile Function (IIEF5+1). The secondary objectives included the analysis of peak-systolic velocities (PSVs), end-diastolic velocities (EDVs), and resistive index (RI), and the estimate of the percentage of men with normal penile hemodynamic parameters after each treatment. RESULTS In all groups of patients taking sildenafil 50 mg, sildenafil 100 mg, tadalafil 20 mg, and vardenafil 20 mg at a frequency reflecting the common treatment regimens in real life, there was a statistically significant baseline-to-end point improvement in subjective perception of erectile function measured by IIEF5+1. When the four groups were compared, the treatments were not different in modifying IIEF5+1 and penile flow parameters. However, the within-group analysis showed that PSV improved in the sildenafil 50 mg group and that PSV together with RI significantly ameliorated in patients receiving 100 mg of sildenafil. Regression analysis confirmed an independent effect of sildenafil on hemodynamic efficacy parameters. CONCLUSIONS An overall equivalence was demonstrated in the subjective perception of treatment benefits for all the PDE5i tested. However, sildenafil, in a dose-dependent manner, was the unique PDE5i able to ameliorate some of the penile flow parameters within the 8-week treatment period. These findings should be interpreted conservatively because of the observational nature of the study.
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Affiliation(s)
- Emmanuele A Jannini
- School of Sexology, Department of Experimental Medicine, University of L'Aquila, Coppito, L'Aquila, Italy.
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Lombardi G, Macchiarella A, Cecconi F, Del Popolo G. Efficacy and Safety of Medium and Long-Term Tadalafil Use in Spinal Cord Patients with Erectile Dysfunction. J Sex Med 2009; 6:535-43. [DOI: 10.1111/j.1743-6109.2008.01106.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Perimenis P, Roumeguere T, Heidler H, Roos E, Belger M, Schmitt H. Evaluation of Patient Expectations and Treatment Satisfaction after 1-Year Tadalafil Therapy for Erectile Dysfunction: The DETECT Study. J Sex Med 2009; 6:257-67. [DOI: 10.1111/j.1743-6109.2008.01027.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Fugl-Meyer A, Althof S, Buvat J, Paget MA, Sotomayor M, Stothard D. Aspects of Sexual Satisfaction in Men with Erectile Dysfunction: A Factor Analytic and Logistic Regression Approach. J Sex Med 2009. [DOI: 10.1111/j.1743-6109.2008.01135.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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