Phosphodiesterase Type 5 Inhibitors for the Management of Erectile Dysfunction: Preference and Adherence to Treatment

Al-Shaiji, Tariq F.; Gb, Brock

doi:10.2174/138161209789206944

Cited by 24 publications

(18 citation statements)

References 62 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tadalafil was the preferred PDE5‐I in our series in line with the published literature [15–17]. This may be explained in part by the fact that tadalafil was the preferred choice of prescription from the andrology clinic, in spite of cost implications [18].…”

Section: Discussionsupporting

confidence: 83%

Management of ED under the “Severe Distress” Criteria in the NHS: A Real-Life Study

Mohee

Bretsztajn

Storey

et al. 2014

The Journal of Sexual Medicine

View full text Add to dashboard Cite

Introduction The United Kingdom is unusual in that a significant proportion of patients with erectile dysfunction (ED) have their treatment fully reimbursed by the National Health Service (NHS). This may have consequences for the choice of treatment and for compliance with treatment. Aims The aim of this study was to evaluate the use and cost implications of phosphodiesterase type 5 inhibitor in an NHS setting. Methods Basic demographics and data on ED management for patients treated from January 2000 to April 2011 were obtained from a prospectively accrued database. We reviewed drug usage and costs as well as switching between drugs. Patients were given the choice of all available therapies and were followed up annually. Main Outcome Measures Switching, compliance, and costs of treating ED under the “severe distress” criteria in the NHS were reviewed for this study. Results Two thousand one hundred fifty-nine patients qualified for reimbursed therapy. Two hundred twenty-six patients were excluded from further analysis owing to missing data. Patients were followed up on an annual basis. The mean patient age was 60.2 years (min 23, max 90), and the mean follow-up was 50.8 months (min 1, max 127). Six hundred ninety-six were started on sildenafil, 990 on tadalafil, 163 on vardenafil, and 84 on intracavernosal alprostadil. Eighteen percent of patients initially started on the scheme and stopped medication unilaterally. Of the patients, 12.3% changed their medication during follow-up. The cost of drugs increased year by year from £257,100 in 2007 to £352,519 in 2011. Conclusions Our real-life observational study shows that in our institution, dropout of therapy is unusual. We hypothesize that this reflects, in part, the reimbursement issue. We also found that switching between drugs was unusual, although there are several possible explanations for that. Although this is a successful system for the patients, the hospital, which bears the costs of medication, is finding this an increasing economic drain.

show abstract

Section: Discussionsupporting

confidence: 83%

Management of ED under the “Severe Distress” Criteria in the NHS: A Real-Life Study

Mohee

Bretsztajn

Storey

et al. 2014

The Journal of Sexual Medicine

View full text Add to dashboard Cite

show abstract

“…P hosphodiesterase type 5 inhibitors (PDE5) are recommended as first-line therapy in the treatment of erectile dysfunction (ED) [1,2]. Although PDE5's are generally effective, many couples discontinue treatment within the first year [3,4]. Notably, ED is a multifactorial experience, including difficulty with physical aspects such as ease of erection and successful completion of intercourse, as well psychosocial aspects such as sexual confidence, impact on relationship, and partner satisfaction [5].…”

Section: Introductionmentioning

confidence: 99%

Treatment Satisfaction of Men and Partners Following Switch from On-Demand Phosphodiesterase Type 5 Inhibitor Therapy to Tadalafil 5 mg Once Daily

Burns

Rosen

Dunn

et al. 2015

The Journal of Sexual Medicine

View full text Add to dashboard Cite

Introduction Treatment satisfaction of men receiving phosphodiesterase 5 inhibitors (PDE5) for erectile dysfunction (ED) and their partners is essential to successful long-term therapy. Aim This study aims to assess treatment satisfaction, in men with a partial response to on-demand (PRN) PDE5 and their female partners, following tadalafil 5 mg once daily or placebo. Methods The study was randomized, double-blind, parallel, and placebo-controlled in men primarily with mild to moderate ED. Treatment satisfaction was assessed following a 4-week maximum dose PRN lead-in, 4-week nondrug washout, and treatment through 12 weeks. Men were ≥18 years old with ED for ≥3 months and International Index of Erectile Function Erectile Function score of ≥17 and <26 at screening and <26 following PRN lead-in. Main Outcome Measures Treatment satisfaction was assessed using the Treatment Satisfaction Scale (TSS) for patients and partners. TSS domain scores range from 0 to 100, with higher values indicating greater satisfaction. Statistical comparisons were made using analysis of covariance. Results Treatment satisfaction was significantly greater with tadalafil once daily vs. placebo across all TSS domains for both patients and their partners (all P < 0.001). For patients, mean scores for the TSS domains Confidence to Complete Sexual Activity and Satisfaction with Orgasm ranged from 53.7 to 57.8 after the PRN lead-in and 26.7 to 31.9 following the nondrug washout. Following randomized treatment, scores for tadalafil and placebo were 55.4 and 32.6, respectively, for Confidence to Complete Sexual Activity and 57.5 and 37.9, respectively, for Satisfaction with Orgasm. Results were comparable for other TSS domains and between men and their partners. Conclusions Treatment satisfaction was comparable for tadalafil 5 mg once daily and PRN PDE5 for both patients and female partners, suggesting that tadalafil once daily is a viable therapy option for men with ED who had a partial response to PRN PDE5 therapy.

show abstract

“…In particular, low treatment success rates have been reported for patients with diabetes and patients who have undergone surgery for prostate cancer. 32 Thus, the development of drugs that can compensate is required. In our study, higenamine increased the concentration of cGMP and cAMP in the CC tissues in a dose-dependent manner.…”

Section: Discussionmentioning

confidence: 99%

The relaxation effect and mechanism of action of higenamine in the rat corpus cavernosum

Kam

Choi

et al. 2011

Int J Impot Res

View full text Add to dashboard Cite

Higenamine mediates cardiotonic, vascular relaxation and bronchodilator effects. The relaxation effects and the mechanism of action of higenamine on the rat corpus cavernosum (CC) were assessed to investigate the effect of higenamine on penile erection. Strips of CC and aorta were used in organ baths for isometric tension studies. Tension was measured with isometric force transducers, and muscle relaxation was expressed as the percent decrease in precontraction induced by phenylephrine (PE). The relaxation reactions were investigated in an endothelial-denuded group and groups pretreated with N(G)-nitro-L-arginine methyl ester (NO synthesis inhibitor), propranolol (b-receptor blocker), indomethacin (COX inhibitor), glibenclamide (K þ ATP channel inhibitor), 4-aminopyridine (membrane potential-dependent potassium channel inhibitor) and methylene blue (guanylyl cyclase inhibitor) for 30 min. Intracavernous pressure (ICP) was assessed in rats after the intravenous administration of higenamine, and changes in guanosine 3 0 ,5 0 -cyclic monophosphate and adenosine 3 0 ,5 0 -cyclic monophosphate (cAMP) concentrations were measured on the basis of the higenamine concentration. Also, the combined reaction of higenamine and the phosphodiesterase type-5 (PDE-5) inhibitors was assessed. Higenamine induced relaxation of the CC and the aortic strips precontracted with PE in a dose-dependent manner. The CC was significantly more relaxed than the aortic rings in response to the same higenamine concentration (Po0.05). The CC relaxation reaction was suppressed by the b-receptor blocker propranolol. The cAMP concentration increased gradually with increased higenamine concentration (Po0.05). The ICP also increased with increased higenamine concentration in vivo (Po0.05). In the group pretreated with 10 À7 M higenamine, the relaxation reaction of CC induced by the PDE-5 inhibitor increased significantly, compared with CC exposed to the PDE-5 inhibitor but not pretreated with higenamine (Po0.05). In conclusion, higenamine induced relaxation of the rat CC in a dose-dependent manner. The effect may be mediated through b-adrenoceptors. The results suggest that higenamine may be valuable as a new lead compound for treating erectile dysfunction.

show abstract

Phosphodiesterase Type 5 Inhibitors for the Management of Erectile Dysfunction: Preference and Adherence to Treatment

Cited by 24 publications

References 62 publications

Management of ED under the “Severe Distress” Criteria in the NHS: A Real-Life Study

Management of ED under the “Severe Distress” Criteria in the NHS: A Real-Life Study

Treatment Satisfaction of Men and Partners Following Switch from On-Demand Phosphodiesterase Type 5 Inhibitor Therapy to Tadalafil 5 mg Once Daily

The relaxation effect and mechanism of action of higenamine in the rat corpus cavernosum

Contact Info

Product

Resources

About