PDE-5 inhibitors in monotherapy versus combination therapy in a sample of 1200 patients with erectile dysfunction

Huerta, L. Labairu; Padilla‐Fernández, Bárbara; Arrondo-Arrondo, José Luis; Valverde-Martínez, Lauro Sebastián; Martín-Rodríguez, Agustín; Silva-Abuín, J.M.; Cenador, María Begoña García; Mirón-Canelo, José Antonio; Lorenzo-Gómez, María Fernanda

doi:10.4081/aiua.2015.3.204

Cited by 9 publications

(5 citation statements)

References 42 publications

(45 reference statements)

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“…The last cohort study, a retrospective analysis, evaluated PDE5i monotherapy versus PDE5i and PG‐E1. Monotherapy had substantially increased patient satisfaction as compared to combination therapy [ 14 ] (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…Questions of combination therapy superiority are not limited to oral medications. Labairu‐Huerta et al [ 14 ] evaluated the efficacy of a variety of combination therapies, including PGE1 and PDE5i. A total of 1200 men were included in the study, with patients split between the monotherapy and combination therapy groups.…”

Section: Discussionmentioning

confidence: 99%

“…In this case, monotherapy had a significant advantage in satisfactory response compared to combination therapy, suggesting that PG‐E1 combination therapy would not improve patient outcomes. This is another example of the efficacy of monotherapy [ 14 ] .…”

Section: Discussionmentioning

confidence: 99%

“…No VED monotherapy control Singh et al [11] 2014 133 3 months Prospective Tamsulosin and tadalafil daily versus tamsulosin daily versus tadalafil daily 3 Combination therapy did not have a significant impact on IIEF scores compared to tadalafil monotherapy Labairu-Huerta et al [14] 2015 [12] . Continuing the evaluation of devices for ED, some studies looked at combination therapy involving VED.…”

Section: Authormentioning

confidence: 99%

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Value of phosphodiesterase 5 inhibitors as a combination therapy for treating erectile dysfunction: A literature review

Owen,

Khalafalla,

Wang

2024

UroPrecision

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Erectile dysfunction (ED) is increasing in prevalence, with estimates that 50% of men between 40 and 70 years of age suffer from the disease. Due to a wide array of available medical interventions, significant focus has been put on combination therapies that can treat ED refractory to first‐line treatments such as phosphodiesterase 5 inhibitors (PDE5is). However, reviews evaluating monotherapy noninferiority and patient satisfaction of monotherapy versus combination therapy are lacking. A thorough PubMed search was performed to evaluate combination therapy in ED treatment. Articles published between January 2008 and June 2023 were reviewed, including randomized control trials, retrospective analyses, and cohort studies. Combination therapies included PDE5i plus another PDE5i, testosterone supplementation, α‐blockers, vacuum erectile devices, intracavernosal injections, and low‐intensity shockwave therapy. Based on this review, PDE5i monotherapy is not inferior to combination therapy and has increased satisfaction, convenience, and ease of use for patients with ED. Limitations of current literature on combination therapy include small sample size, limited data on patient satisfaction, possible biases, and limited follow‐up time. Further studies will need larger randomized control trials with follow‐up times greater than 1 year.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Authormentioning

confidence: 99%

See 2 more Smart Citations

Value of phosphodiesterase 5 inhibitors as a combination therapy for treating erectile dysfunction: A literature review

Owen,

Khalafalla,

Wang

2024

UroPrecision

View full text Add to dashboard Cite

show abstract

“…The basic science literature has confirmed the necessity of androgens to generate adequate intracavernosal pressures and smooth muscle function to obtain an erection [59]. The literature showing the impact of testosterone replacement therapy (TRT) on erectile function is quite heterogenous (Table 1) [6061626364656667686970717273747576777879808182838485868788899091]. A subset analysis of the Olmstead County Cohort published by Gades et al [92] showed that testosterone has a statistically significant positive correlation with erectile function, even when adjusted for age.…”

Section: Hypogonadismmentioning

confidence: 99%

Modifying Risk Factors in the Management of Erectile Dysfunction: A Review

DeLay

Haney

Hellstrom

2016

World J Mens Health

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Erectile dysfunction (ED) is prevalent among men and its presence is often an indicator of systemic disease. Risk factors for ED include cardiovascular disease, hypertension, diabetes mellitus (DM), tobacco use, hyperlipidemia, hypogonadism, lower urinary tract symptoms, metabolic syndrome, and depression. Addressing the modifiable risk factors frequently improves a patient's overall health and increases lifespan. The literature suggests that smoking cessation, treatment of hyperlipidemia, and increasing physical activity will improve erectile function in many patients. How the treatment of DM, depression, and hypogonadism impacts erectile function is less clear. Clinicians need to be aware that certain antihypertensive agents can adversely impact erectile function. The treatment of men with ED needs to address the underlying risk factors to ameliorate the disease process.

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Non-invasive Management Options for Erectile Dysfunction When a Phosphodiesterase Type 5 Inhibitor Fails

Lee

Sharifi

2018

Drugs Aging

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Phosphodiesterase type 5 inhibitors (PDE5Is) are the drug of choice for medical management of erectile dysfunction (ED). On-demand PDE5Is have an overall efficacy of 60-70% for ED; 30-35% of patients fail to respond to a PDE5I, and 30-50% of non-responders can be salvaged with detailed counseling on proper use and physician follow-up to ensure that the patient has been prescribed an appropriate and full PDE5I clinical trial. True non-responders may be offered intracavernosal injections of erectogenic drugs, intraurethral alprostadil, or surgical insertion of a penile prosthesis. Such options are not discreet and are associated with more adverse effects than PDE5Is. Thus patients may request additional non-invasive medical management options. This review describes published literature on patients who failed to respond to an on-demand PDE5I regimen and were treated with a non-invasive PDEI-based regimen, including switching from one PDE5I to another; increasing the dose of PDE5I above the labeled dosage range; using two PDE5Is concurrently; using a daily PDE5I regimen; or combining a PDE5I with a testosterone supplement, α-adrenergic antagonist, intraurethral or intracavernosal alprostadil, vacuum erection device, or low-intensity shock wave therapy. The limitations of published clinical trials do not allow for sufficient evidence to recommend one option over another. Therefore, in PDE5I-refractory patients, the choice of a specific next step should be individualized based on the preference of the patient and his sexual partner, the advantages and disadvantages of the various options, the concurrent medical illnesses and medications of the patient, and the patient's response to treatment.

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PDE-5 inhibitors in monotherapy versus combination therapy in a sample of 1200 patients with erectile dysfunction

Abstract: Objectives: To compare the effectiveness in the treatment of erectile dysfunction when using PDE-5 inhibitors (PDE5i), alprostadil (PG-E1) and testosterone (TES) in SummaryNo conflict of interest declared.

Cited by 9 publications

References 42 publications

Value of phosphodiesterase 5 inhibitors as a combination therapy for treating erectile dysfunction: A literature review

Value of phosphodiesterase 5 inhibitors as a combination therapy for treating erectile dysfunction: A literature review

Modifying Risk Factors in the Management of Erectile Dysfunction: A Review

Non-invasive Management Options for Erectile Dysfunction When a Phosphodiesterase Type 5 Inhibitor Fails

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