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Changhee Yoo, Jinsung Park, Wansuk Kim, Bumsik Hong
, Junhyuk Hong, Tai Young Ahn
, Junhyuk Hong, Tai Young Ahn
Abstract
Purpose
To compare the clinical efficacy and safety of three phosphodiesterase type 5 (PDE5) inhibitors in the treatment of mele erectile dysfunction according to patient preference.
Materials and Methods
Between January 2004 and August 2005, 113 male erectile dysfunctional patients were enrolled to this randomized, prospective, comparative, open-label, triple-crossover study of three PDE5 inhibitors. Patients were assigned to one of six medication schedules, and were prescribed a full dose of the drugs for 8 weeks, with a week of washout period prior to the next drug cycle. The International Index of Erectile Function (IIEF) scores and side effects related with each medication were obtained at the end of study. 48 patients finished all the medications, and completed the study with a global assessment questionnaire on their drug preference and reasons for that preference.
Results
The mean age of the patients was 54.6 (33-73) years. The mean pre-treatment IIEF and EF domain scores (±S.D.) were 28.2±14.7 and 10.6±6.6, respectively. The scores were significantly improved, to 47.9±14.6 and 19.9±6.6 with sildenafil, to 49.7±12.3 and 21.3±5.8 with vardenafil, and to 47.9±14.9 and 19.8±7.2 with tadalafil (p<0.01). There were no significant differences in the scores or frequencies of side effects between the drugs. The preference percentages were 29.2, 29.2 and 35.4% for sildenafil, vardenafil and tadalafil, respectively. Patient preference was mainly due to improvement in erectile function (70.9%), such as rigid erection, prolonged erection and fast erection, and not to the infrequent rate of side effects (20.8%).
Figures and Tables
Fig. 1
Study design: patients were enrolled and assigned to one of six different medication schedules, according to prescription of drug sequence, and were prescribed a full dose of each PDE5 inhibitors (sildenafil 100mg; vardenafil 20mg; tadalafil 20mg) for 8 weeks, with a week of washout period, prior to the next drug cycle. IIEF and EF domain scores, responses to a general assessment questionnaire, and side effects were checked at the end of each period. 48 patients completed the study to the final questionnaire on their drug preference, and gave their reason for this preference. IIEF: International Index of Erectile Function.
Fig. 2
Changes in the IIEF and EFD scores before and after treatment with three phosphodiesterase type 5 (PDE5) inhibitors. IIEF: International Index of Erectile Function, EFD: erectile function domain. p<0.01: when post-treatment IIEF and EFD scores of the 3 PDE5 inhibitors were compared with pre- treatment scores.
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