• 
• 
• 
• 
• 
• 
• 

• 
• 
• 
• 

• 
• 
• 

• 
• 
• 
• 
• 

Erectile dysfunction and lower urinary tract symptoms secondary to BPH

Prescribing All Phosphodiesterase 5 Inhibitors to a Patient with Erectile Dysfunction—A Realistic and Feasible Option in Everyday Clinical Practice—Outcomes of a Simple Treatment Regime

Ströberg P, Hedelin H, Ljunggren C; Eur Urol 2005;49: 900–907.

KEY WORDS: Erectile dysfunction, PDE5 inhibitors, Sildenafil, Vardenafil, Tadalafil, Preference, Clinical practice

Studies from the industry tend to favor their own drug, whereas independent studies tend to show no major difference in preference. So there is a lack of overwhelming reliable data showing that one PDE5 inhibitor is superior to another. Thus, a current opinion is that the individual patient should have the opportunity to test all three drugs and then select the one that suits him and his partner best. In clinical practice, the authors try to apply and evaluate outcomes of a treatment regime, in which a total of 186 patients (of which 34% had not been treated previously and 66% were undergoing treatment for their Erectile Dysfunction – ED) had the opportunity to try all the available phosphodiesterase 5 (PDE5) inhibitors.

• Of all patients studied, the overall treatment response was 89% (165 of 186 patients); 78% tested all three substances. No significant difference in choice between long- and shorter-acting medications in the overall material was observed. Two thirds of the naïve patients preferred a shorter-acting substance (p <0.01). Every fifth man requested both a shorter- and a long-acting medication to accommodate his need.
• If patients are given the opportunity in clinical practice to try all three available PDE5 inhibitors, the overall response rate is very high, almost 90%. No significant difference in patient preference between long- and shorter-acting drugs was observed. Treatment choice was based mainly on efficacy or duration of effect.

See the abstract

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16564126