Comparison of efficacy for erectile function and lower urinary tract symptoms of tadalafil 20 mg on‐demand and 5 mg once daily in patients with erectile dysfunction

Summary Aim:  To compare the improvement in erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) as well as safety of tadalafil dosed at 20 mg on‐demand and 5 mg once daily among ED patients. Materials and methods:  A total of 194 ED patients visited between March 2010 and June 2011 were recruited. Out of 194 individuals, 168 (86.6%) met inclusion criteria after completing the two‐week screening period (V0). The Patients were randomly allocated into two groups: (i) 20 mg of tadalafil as needed (Group 1: n  =   84, 50.0%) and (ii) 5 mg of tadalafil once daily (Group 2: n  =   84, 50.0%). Blood pressure (BP), heart rate (HR) and the five‐item version of the International Index of Erectile Function (IIEF‐5) were assessed immediately before initiation of treatment (V1) and after four (V2) and twelve weeks of treatment (V3). In men with an IPSS of ≥ 8 at V1, IPSS, maximal flow rate (Qmax) and post‐void residual volume (PVR) were also assessed. Results:  Of the 168 patients, 134 (79.8%; Group 1: n  =   68, 81.0%; Group 2: n  =   66, 78.6%) patients completed the trial. IIEF‐5 improved in both groups, and the mean change was larger in Group 2 at V3 (4.9 ± 4.2 vs. 6.5 ± 4.5; p =   0.032) Similarly, though IPSS (with ≥ 8, n  =   88, 65.7%; Group 1: n  =   44, 64.7%; Group 2: n  =   44, 66.7%) improved in both groups, the mean change was larger in Group 2 at V3 (−2.8 ± 4.3 vs. −4.8 ± 4.1; p =   0.026). Qmax and PVR did not differ significantly in either group. Conclusions:  Once daily tadalafil was more efficacious in treating both ED and LUTS than on‐demand dosing. However, no differences were observed between the two dosing schedules with regard to the improvement in LUTS when stratified by improvement in ED. The side effects were insignificant for both dosing schedules.