In the meta- analysis , tadalafil and sildenafil appeared to have similar efficacies and overall adverse event rates .
However , compared with sildenafil , tadalafil significantly improved psychological outcomes .
Furthermore , the patients and their partners preferred tadalafil over sildenafil , and no significant difference was found in the adherence and persistence rates between tadalafil and sildenafil .
Additionally , the myalgia and back pain rates were higher and the flushing rate was lower with tadalafil than with sildenafil .
Conclusion Tadalafil shares a similar efficacy and safety with sildenafil and significantly improves patients ’ sexual confidence .
Furthermore , patients and their partners prefer tadalafil to sildenafil .
Hence , tadalafil may be a better choice for ED treatment
Aims Erectile dysfunction ( ED ) is a major care problem worldwide .
Tadalafil and sildenafil are the two most common phosphodiesterase 5 inhibitors used to treat ED .
This systematic review and meta- analysis were conducted to directly compare tadalafil with sildenafil for the treatment of ED .
A multicenter, randomized, double-blind, crossover study to evaluate patient preference between tadalafil and sildenafil.
PURPOSE To assess  patient preference for erectile dysfunction  treatment between either sildenafil or tadalafil , each administered with their respective dosing instructions , and to evaluate preference for either sildenafil or tadalafil dosing instructions during tadalafil therapy . METHODS We conducted a r and omized , double-blind , crossover study consisting of four treatment arms . Because the dosing instructions for sildenafil and tadalafil are different , a unique methodology using sham placebo arms was employed to maintain the blind . To assess drug preference , 219 patients were r and omized to either sildenafil 50 mg or tadalafil 20 mg , with dosing instructions reflecting their respective product profiles . To assess dosing instruction preference during tadalafil therapy , 46 patients were r and omized to tadalafil 20 mg with either tadalafil or sildenafil dosing instructions . After 12 weeks , patients were crossed-over . After 4 weeks of each treatment , all patients following sildenafil dosing instructions were offered the opportunity for an upward dose titration . In a double-blind fashion , all patients who requested an upward titration received additional capsules . To mimic the pattern of dose usage observed in clinical practice , the number of patients who received additional double-blind active medication was limited to 35 % of patients taking sildenafil  in each treatment period in each country . Following the crossover treatment period , patients chose their preferred double-blind treatment with dosing instructions to receive in the 12-week extension period . RESULTS In the drug preference assessment , 132 of 181 ( 73 % ) evaluable patients chose to receive tadalafil ( p < 0.001 ) during the extension period . In the dosing instruction preference assessment , 24 of 36 ( 67 % ) evaluable patients preferred tadalafil with tadalafil dosing instructions ( p = 0.046 ) . Sildenafil and tadalafil were well tolerated . CONCLUSIONS In the doses utilized in this study , 73 % of patients preferred tadalafil with tadalafil dosing instructions for the treatment of their erectile dysfunction over sildenafil with sildenafil dosing instructions . During tadalafil therapy , 67 % of patients preferred tadalafil dosing instructions over sildenafil dosing instructions
In the meta- analysis , tadalafil and sildenafil appeared to have similar efficacies and overall adverse event rates .
However , compared with sildenafil , tadalafil significantly improved psychological outcomes .
Furthermore , the patients and their partners preferred tadalafil over sildenafil , and no significant difference was found in the adherence and persistence rates between tadalafil and sildenafil .
Additionally , the myalgia and back pain rates were higher and the flushing rate was lower with tadalafil than with sildenafil .
Conclusion Tadalafil shares a similar efficacy and safety with sildenafil and significantly improves patients ’ sexual confidence .
Furthermore , patients and their partners prefer tadalafil to sildenafil .
Hence , tadalafil may be a better choice for ED treatment
Aims Erectile dysfunction ( ED ) is a major care problem worldwide .
Tadalafil and sildenafil are the two most common phosphodiesterase 5 inhibitors used to treat ED .
This systematic review and meta- analysis were conducted to directly compare tadalafil with sildenafil for the treatment of ED .