For common outcomes there was similar efficacy between PDE-5 inhibitors
Background There are no r and omised and properly blinded trials directly comparing one PDE-5 inhibitor with another in a normal home setting .
Valid indirect comparisons with a common comparator must examine equivalent doses , similar duration , similar population s , with the same outcomes reported in the same way .
A multicenter, randomized, double-blind, crossover study of patient preference for tadalafil 20 mg or sildenafil citrate 50 mg during initiation of treatment for erectile dysfunction.
BACKGROUND Tadalafil is a phosphodiesterase 5 ( PDE5 ) inhibitor approved in > 30 countries for the treatment of erectile dysfunction ( ED ) . It has been shown to improve erectile function compared with placebo in Phase III studies , but clinical experience comparing tadalafil with the PDE5 inhibitor sildenafil citrate is lacking . OBJECTIVE This study compared patient preference for tadalafil 20 mg or sildenafil 50 mg during initial treatment for ED . It also compared the tolerability of the 2 agents at these doses . METHODS This r and omized , double-blind , fixed-dose , 2-period crossover trial took place at 13 sites in the United States and Germany . Patients were r and omized 1:1 to receive 4 weeks of treatment with tadalafil 20 mg or sildenafil 50 mg , followed by the alternative treatment , to be taken as needed up to once daily before sexual activity . RESULTS The study enrolled 215 men with ED , 109 r and omized to the tadalafil-sildenafil sequence and 106 to the sildenafil-tadalafil sequence . Their mean age was 49.8 years ; 84.7 % were sildenafil naive and 15.3 % had undergone a previous inadequate trial of sildenafil . Most patients had moderate ED ( 60.5 % ) of > or=1 year 's duration ( 74.9 % ) . Of 190 evaluable patients , 126 ( 66.3 % ) preferred to initiate treatment with tadalafil , compared with 64 ( 33.7 % ) with sildenafil ( P < 0.001 ) . Patients ' preference did not differ by age , duration of ED , treatment sequence , or previous sildenafil exposure . Both medications were well tolerated , with no significant differences in the incidence of treatment-emergent adverse events . Headache ( 11.2 % tadalafil , 8.8 % sildenafil ) , dyspepsia ( 6.0 % and 4.2 % , respectively ) , nasopharyngitis ( 4.7 % and 2.8 % ) , and flushing ( 2.8 % and 4.7 % ) were the most common adverse events . The rate of ocular disturbances was low : 1 patient experienced intermittent bilateral reduction in visual acuity with tadalafil , and 2 exhibited conjunctival hyperemia or eyelid edema with sildenafil . CONCLUSIONS Tadalafil 20 mg was preferred to sildenafil 50 mg for the initiation of ED therapy in this study population . Both medications were well tolerated
For common outcomes there was similar efficacy between PDE-5 inhibitors
Background There are no r and omised and properly blinded trials directly comparing one PDE-5 inhibitor with another in a normal home setting .
Valid indirect comparisons with a common comparator must examine equivalent doses , similar duration , similar population s , with the same outcomes reported in the same way .