Prevalence and detection rate of underlying disease in men with erectile dysfunction receiving phosphodiesterase type 5 inhibitors in the United Kingdom: a retrospective database study

Abstract

Summary Aim: To determine the rate of newly detected underlying disease in men receiving their first (index) phosphodiesterase type 5 inhibitor (PDE5i) prescription. Methods: This non‐interventional, retrospective study used anonymised patient records from UK general practices identified from the THIN database. Records of men aged ≥ 18 years, who received an index PDE5i prescription between January 1999 and June 2008 and with a continuous medical history (≥ 60 months) before the index prescription were included. Primary end‐points were the prevalence of underlying disease prior to the index prescription and to establish the detection rate, defined as cumulative incidence of such a diagnosis in the 3 months following the index prescription. Assessments included comparison with age‐matched controls, comparison with identical time periods immediately before and 1 year after, index prescription, and changes over time during the study period. Descriptive statistics, analysis of proportions and multivariate logistic regression analysis were used. Results: Among the 24,708 patients receiving a PDE5i, the prevalence of any underlying diagnosis before the index prescription was 70.23%; prevalence of vasculogenic disease was highest (48.20%). The detection rate of any underlying disease was 11.53%, and again highest for vasculogenic disease (4.07%). Compared with an age‐matched control population, the additional detection rate of an unknown underlying disease at PDE5i prescription was 45 for hypertension, 61 for hypercholesterolaemia, 38 for diabetes and 5 for hypogonadism per 10,000 men. Conclusion: Only a minority of men with erectile dysfunction have a previously undiagnosed important underlying disease that is uncovered at the time of an initial PDE5i prescription by a GP.

Relationship between age and erectile dysfunction diagnosis or treatment using real-world observational data in the USA

“…However, the prevalence of depression (9.1% and 11.1%) was somewhat higher than that in this study (7.0%). Consistent with the present results, the prevalence of comorbid conditions was significantly higher in men with ED than in men without ED . Multivariate analysis estimated that the risk of diabetes, hypertension and depression were increased, overall and across age groups …”

“…The results of this study were generally consistent with previously published results of real‐world observational data. Previous studies have assessed the prevalence of underlying comorbidities in men with ED using data from US health insurance claims databases and in men from a UK general practice EHR database . The age distribution of the men was not reported in the UK study, but the reported age distribution of men with ED in the US studies (5%‐7% aged ≤35 years; 16%‐17% aged 36‐45 years; 34%‐36% aged 46‐55 years; 34%‐36% aged 56‐65 years; 5%‐7% aged 66‐75 years; and 2% aged ≥76 years) was broadly similar to that of this study.…”

The SIAMS-ED Trial: A National, Independent, Multicentre Study on Cardiometabolic and Hormonal Impairment of Men with Erectile Dysfunction Treated with Vardenafil

“…However, we also diagnosed unknown cardiovascular or metabolic disorders in 24% of our ED subjects (Figures 2 and 3). These numbers are nearly double those reported in a recent UK study [37], where the rate of discovery of previously unknown conditions was 11.53%. The discrepancy is likely due to methodological differences, rather than regional characteristics.…”

Prognostic value of exercise capacity among men undergoing pharmacologic treatment for erectile dysfunction: The FIT Project

“…Although we did not use a questionnaire to assess for ED symptoms, that method can be subject to desirability bias, and medication use is a more objective method to characterize ED. Prior studies have likewise utilized the prescription of phosphodiesterase inhibitors as a proxy for the presence of ED …”

“…Prior studies have likewise utilized the prescription of phosphodiesterase inhibitors as a proxy for the presence of ED. 7,8,24 Alternatively, our sample may be confounded by a treatment bias, as patients who are healthier and have higher socioeconomic status may be more likely to undergo treatment for ED. The men in our sample were also relatively fit, with the average participant able to achieve 10.2 METs.…”