| 1 Room 524-C | Sexuality, Desire and Pleasure Thursday, July 14, 2005 Time: 2:30 PM-4:30 PM |
Comparing the three PDE-5 inhibitors in the same population.
Yassin, Aksam*,1,2, Saad, Farid3,4, 1 Clinic of Urology / Andrology, Norderstedt-Hamburg, Schleswig-Holstein, Germany2 Gulf Medical College School of Medicine, Ajman, UAE3 SBU Andrology, Male Health Care, Schering AG, Berlin, Berlin, Germany4 Gulf Medical College School of Medicine, Ajman, UAE
ABSTRACT- Objective: this independent prospective, cross-over, observational and open-label study was undertaken to assess both efficacy, patients´ preference and side-effect profile of Sildenafil, Tadalafil and Vardenafil in the same population. Methods: during June 2003 and June 2004, six-hundred forty-one patients were recruited to be treated in three equal groups in four-months´ cycles with Sildenafil, 25, 50 or 100 mg; Tadalafil, 10 or 20 mg and Vardenafil, 10 or 20 mg, i.e. the optimal dosages. We assessed the onset of efficacy in minutes after intake, IIEF, side-effect profile and partner satisfaction. Etiology of ED was psychogenic (23%) or of different organic geneses (77%) incl. diabetics (144 of 585 pat. = 20 %). Average age = 59 years (21 – 72). True responders were investigated by means of a partner assessment questionnaire (asking 4 questions: erectile quality/rigidity, duration of erection, successful intercourse completion and frequency), scaled from 1 = insufficient, 2 = medium, to 3 = sufficient to good. Results: Deducting 19 dropouts and 37 non-evaluated patients who did not complete the study, just 585 subjects could be properly evaluated. The onset of Vardenafil was the fastest, i.e. 5-17 minutes. Fastest flooding of the plasma level was reached by Vardenafil 20 mg, followed by Sildenafil and Tadalafil. Overall satisfaction was approximately the same in all three of the substances, however, with more approval for Sildenafil, possibly due to economic reasons as it´s easier to divide. The decision of younger patients (< 55 years) was in favour of Tadalafil. Diabetics (114 pat.) plainly preferred Vardenafil. The partner assessment of true responders showed an overall satisfaction with Sildenfil, Tadalafil and Vardenafil. Conclusion: In terms of efficacy and contentment all 3 substances did equally good. The preferences varied between economically (Sildenafil which is easy to divide in 2 or 4 pieces), speed of onset and penile rigidity (Vardenafil). An age dependent preference in rather young patients was remarkable. Those between 40 and 55 preferred Tadalafil, most probably due to its longer elimination time till 36 hours.
Key words: ED, PDE-5 inhibitors, true responders, partner assessment