Efficacy and safety of combination of tadalafil and aspirin versus tadalafil or aspirin alone in patients with vascular erectile dysfunction: a comparative randomized prospective study

Assessment of Combination Therapies vs Monotherapy for Erectile Dysfunction

“…63,64 Across the included trials, sildenafil citrate and tadalafil were the preferred PDE5 inhibitors. 63,64 Some studies examined PDE5 inhibitors as a continuous daily, low-dose drug, 21,[23][24][25][27][28][29][30]33,[39][40][41][42]56,58,63 whereas other studies evaluated it as an on-demand, high-dose agent taken prior to intercourse. 22,26,31,32,[34][35][36][37][38][43][44][45][46][47][48][49][50][51][52][53][54][55]57,[59][60][61]64 The study selection process is illustrated in eAppendix 2 and 3 in the Supplement, and the characteristics of all included studies are described in the Table.…”

“…A total of 44 studies with 3853 men were included in the qualitative synthesis . The mean (SD) patient age was 55.8 (11.9) years.…”

“…The overall risk of bias was low in 12 RCTs, 23,25,26,29,33,34,41,43,45,47,49,50 with some concerns found in 16 RCTs 21,22,27,28,30,35,38,39,44,46,48,[51][52][53]62,64 and high risk of bias in 8 RCTs 24,31,32,36,37,40,42,61 (eAppendix 4 in the Supplement). Accordingly, 3 non-RCTs 54,57,63 were considered as having low risk of bias and 5 non-RCTs 54,56,[58][59][60] as having moderate risk of bias (eAppendix 5 in the Supplement).…”

A comparative Study of Tadalafil versus Tadalafil combined with Alpha Lipoic Acid in the treatment of Erectile Dysfunction in Diabetic Patients

“…5 PDE5i hydrolyzes cyclic guanylate monophosphate (cGMP) particularly to 5′GMP that cause penile cavernous smooth muscle relaxation and penile erection. 4 Alpha-lipoic acid (ALA) is a potent biological antioxidant that is known as a "universal antioxidant" owing to its solubility in both water and fat. ALA is easily absorbed from the intestines and crosses the blood-brain barrier with ease, leading to optimal bioavailability.…”

“…PDE5i is responsible for the hydrolysis of cyclic guanylate monophosphate (cGMP) to 5′GMP, which causes penile cavernous smooth muscle relaxation and penile erection. 4 Diabetic erectile dysfunction (DED) is a form of ED that is a subtype of endocrine erectile dysfunction (EED). It's one of the most frequent reasons for dysfunction in diabetics, with a complicated pathophysiology.…”