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 .
Switching patients with erectile dysfunction from sildenafil citrate to tadalafil: results of a European multicenter, open-label study of patient preference.
BACKGROUND Three inhibitors of phosphodiesterase 5 ( PDE5 ) are now available for the treatment of erectile dysfunction ( ED ) : sildenafil citrate , vardenafil , and tadalafil . Pharmacologic differences between these compounds may result in patient preferences for one over another and may influence treatment decisions made by the physician and patient . Therefore , clinical research is needed to investigate whether individual properties of the PDE5 inhibitors play a role in shaping patient preference . OBJECTIVES The goal of this study was to determine what proportion of ED patients currently taking sildenafil  would , after a period of treatment with tadalafil , elect to resume treatment with sildenafil at the customary dose and what proportion would elect a switch to tadalafil 20 mg for a longer period . The tolerability of both treatments was also investigated . METHODS This was a short-term , multicenter , open-label , 1-way crossover trial conducted in Sweden and Italy . Eligible patients included men aged > or=18 years with a minimum 3-month history of ED who had been taking sildenafil at stable fixed doses of 25 , 50 , or 100 mg as needed for at least 6 weeks and up to 24 weeks . The study consisted of 6 phases : a 1-week screening phase , a 3-week sildenafil assessment phase , a 1-week washout phase , a 6-week tadalafil initiation phase , a 3-week tadalafil assessment phase , and a 6-month extension phase , during which patients received their treatment of choice free of charge . The primary outcome measure was the proportion of patients electing to take sildenafil or tadalafil during the extension phase . RESULTS Of 155 men enrolled , 147 ( 97.8 % ) completed the assessment phases of the trial . Of these 147 men , 133 ( 90.5 % ) elected to receive tadalafil in the 6-month extension phase and 14 ( 9.5 % ) elected to receive sildenafil ( P < 0.001 ) . The proportions preferring tadalafil to sildenafil  were similar irrespective of age group ( > or=50 years , 92 % ; < 50 years , 90 % ) , severity of ED ( mild , 95 % ; moderate , 88 % ; severe , 96 % ) , etiology of ED ( psychogenic , 94 % ; organic , 91 % ; mixed , 87 % ) , and  sildenafil dose at study entry ( 50 mg , 90 % ; 100 mg , 89 % ) . Both medications were well tolerated . The most common treatment-emergent adverse events occurring in > or=2 % of patients during the tadalafil assessment phase included headache ( 4.8 % ) , nasal congestion ( 4.1 % ) , dyspepsia ( 3.4 % ) , flushing ( 2.7 % ) , back pain ( 2.0 % ) , diarrhea ( 2.0 % ) , and nausea ( 2.0 % ) ; the most common treatment-emergent adverse events during the sildenafil assessment phase were flusing ( 7.1 % ) , nasal congestion ( 6.5 % ) , headache ( 4.5 % ) , and nasopharyngitis ( 3.2 % ) . CONCLUSIONS In this short-term , open-label study , patients who were currently taking sildenafil for ED and then received  tadalafil preferred to continue oral therapy with tadalafil over sildenafil by a ratio of approximately 9:1 . Although the study sought to mimic the experience of actual patients receiving treatment for ED , the results are subject to potential limitations due to the design of the study , which included differences in dosing instructions and dosages for sildenafil and tadalafil . Both sildenafil and tadalafil 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 .