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Tadalafil ‘first-choice’ for erectile dysfunction

Tadalafil is the most effective phosphodiesterase type-5 (PDE5) inhibitor for men with erectile dysfunction, according to a new meta-analysis.

The study

Researchers from Hong Kong and China reviewed 118 randomised controlled trials that compared different oral PDE5-inhibitors or looked at their performance versus placebo for men with erectile dysfunction. They assessed the outcomes using question one from the Global Assessment Questionnaire: ‘While using the study medication, did you feel that your erections improved?’ Change from baseline to study end was assessed using the International Index of Erectile Function-Erectile Function domain score. A total of 31,195 patients were included in the analysis.

The findings

Tadalafil scored the highest on the Global Assessment Questionnaire with an absolute treatment effect mean of 0.75. Sildenafil and vardenafil followed on 0.73. Tadalafil also scored highest on the erectile dysfunction domain score with 9.21. Vardenafil was next on 8.39.

What does it mean for GPs?

The authors noted that tadalafil was ‘likely to be the most effective PDE5-inhibitors for erectile dysfunction, followed by vardenafil,’ advising that ‘because taladafil also has many other advantages, such as patient preference, it may be considered first-choice for erectile dysfunction patients.’

European Urology 2013, online 31 January

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