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 .
Randomized, Double-Blind, Placebo-Controlled Trial of Sildenafil (Viagra®) for Erectile Dysfunction After Rectal Excision for Cancer and Inflammatory Bowel Disease
Abstract PURPOSE : Controlled trials have demonstrated the efficacy of sildenafil for “ mixed etiology ” erectile dysfunction , but this may not be the case if there is underlying pelvic parasympathetic nerve damage . We aim ed to determine the efficacy of sildenafil after rectal excision for rectal cancer and inflammatory bowel disease . METHODS : Patients with erectile dysfunction after rectal excision were r and omly assigned in a double-blind manner to sildenafil or placebo groups . After unblinding , placebo patients crossed over to open sildenafil . Primary end points were improvement in erectile function on a global efficacy question and erectile function question naire scores . Secondary end points were frequency and severity of side effects . RESULTS : Thirty-two patients were r and omly assigned , and two dropped out before r and omization . Fourteen received sildenafil , and 18 received placebo . Eleven ( 79 percent ) of 14 responded to sildenafil , on global efficacy assessment , compared with 3 ( 17 percent ) of 18 taking placebo ( mean difference , 61.9 percent ; 95 percent confidence interval , 34.4 to 89.4 percent ; P = 0.0009 ) . Sildenafil improved both erectile function domain scores ( mean difference , 13.3 ; 95 percent confidence interval , 7.9 to 18.7 ; P = 0.0001 ) and total International Index of Erectile Function scores ( mean difference , 30.6 ; 95 percent confidence interval , 18.7 to 42.6 ; P < 0.0001 ) from pretreatment baseline scores . Placebo did not produce improvement in either erectile function ( mean difference , 1.7 ; 95 percent confidence interval , −0.8 to 4.2 ; P = 0.16 ) or total International Index of Erectile Function scores ( mean difference , 5 ; 95 percent confidence interval , −1.1 to 11.1 ; P = 0.1 ) . Ten ( 100 percent ) of 10 crossover patients not responding to placebo did respond to sildenafil ( difference , 100 percent ; P < 0.0001 ) . Sildenafil improved both erectile function domain scores ( mean difference , 16.8 ; 95 percent confidence interval , 9.7 to 24 ; P = 0.002 ) and total International Index of Erectile Function scores ( mean difference , 29.5 ; 95 percent confidence interval , 15.8 to 43.2 ; P = 0.003 ) from precrossover baseline scores . Seven ( 50 percent ) of 14 patients on sildenafil compared with 4 ( 22 percent ) of 18 on placebo experienced side effects ( difference , 28 percent ; 95 percent confidence interval , −4.4 to 60.4 percent ; P = 0.14 ) , 91 percent of which were mild and well tolerated . CONCLUSION : Sildenafil completely reverses or satisfactorily improves postproctectomy erectile dysfunction in 79 percent of patients . Side effects are usually mild and well tolerated . The damage incurred by the pelvic nerves after proctectomy , less profound than after prostatectomy , is likely to result in a partial parasympathetic nerve lesion
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 .