Open AccessTreatment response to sildenafil in men with erectile dysfunction relative to concomitant comorbidities and age
Author(s) -
Goldstein Irwin,
Stecher Vera,
Carlsson Martin
Publication year - 2017
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.12939
Subject(s) - medicine , erectile dysfunction , sildenafil , comorbidity , placebo , diabetes mellitus , concomitant , population , minimal clinically important difference , depression (economics) , randomized controlled trial , endocrinology , alternative medicine , environmental health , pathology , economics , macroeconomics
Summary Aim To evaluate treatment response in men with erectile dysfunction ( ED ) and concomitant comorbidities. Methods Data were pooled from 42 placebo‐controlled, flexible‐dose sildenafil trials. In most trials, the sildenafil dose was 50 mg, taken ~1 hour before sexual activity but not more than once daily, with adjustment to 100 or 25 mg as needed. The overall population (N=9413) was stratified by age (<45, 46‐64, ≥65 years). Treatment response was defined as a minimal clinically important difference ( MCID ) from baseline in the International Index of Erectile Function–Erectile Function ( IIEF ‐ EF ) domain score of >2, >5 and >7 for men with mild, moderate and severe ED at baseline, respectively, or an IIEF ‐ EF domain score ≥26 (no ED ) at end‐point. Results In the overall population, treatment response using the IIEF ‐ EF MCID definition was significantly greater ( P <.0001) with sildenafil vs placebo in men with no comorbidity (77% vs 33%), cardiovascular disease/hypertension only (71% vs 27%), diabetes only (63% vs 24%) or depression only (78% vs 29%). Using an IIEF ‐ EF score ≥26, treatment response was significantly greater ( P <.0001) with sildenafil vs placebo in men with no comorbidity (49% vs 17%), cardiovascular disease/hypertension only (48% vs 12%), diabetes only (40% vs 12%) or depression only (60% vs 17%). With each definition, the treatment response for each age and comorbidity was significantly greater ( P ≤.0065) with sildenafil vs placebo. Conclusion The treatment response was significantly greater with sildenafil vs placebo in men with ED and each comorbidity regardless of age.