Wagner G, Montorsi F, Auerbach S, Collins M
University of Copenhagen, Division of Sexual Physiology, Rigshospitalet, Denmark.
J Gerontol A Biol Sci Med Sci. 2001 Feb;56(2):M113-9. doi: 10.1093/gerona/56.2.m113.
The prevalence of erectile dysfunction (ED) increases with advancing age, with a particularly high prevalence of ED in elderly patients with diabetes. In the United States it is estimated that approximately 45% of men aged 65 to 69 years have moderate or complete ED. The efficacy and safety of oral sildenafil (VIAGRA) for treating ED in elderly men (aged > or = 65 years or older) were assessed.
We analyzed data obtained from five double-blind, placebo-controlled studies of the efficacy and tolerability of oral sildenafil taken as required (but not more than once daily) over a 12-week to 6-month period. Two subgroups were evaluated: (i) elderly patients with ED of broad-spectrum etiology (n = 411), and (ii) elderly patients with ED and diabetes (n = 71). Efficacy was assessed using a global efficacy question, questions 3 and 4 of the International Index of Erectile Function (IIEF). and the five sexual function domains of the IIEF.
All efficacy assessments indicated that sildenafil significantly improved erectile function both in elderly patients with ED of broad-spectrum etiology and in elderly patients with ED and diabetes. The most common adverse events were mild-to-moderate headache, flushing, and dyspepsia. The rates of discontinuation due to adverse events were low and were comparable to the rates with placebo.
Sildenafil is an efficacious and well-tolerated treatment for ED in elderly men.
勃起功能障碍（ED）的患病率随年龄增长而增加，糖尿病老年患者中ED的患病率尤其高。在美国，据估计65至69岁的男性中约45%患有中度或完全性ED。评估了口服西地那非（伟哥）治疗老年男性（年龄≥65岁）ED的疗效和安全性。
我们分析了从五项双盲、安慰剂对照研究中获得的数据，这些研究涉及按需服用（但每日不超过一次）口服西地那非12周至6个月的疗效和耐受性。评估了两个亚组：（i）病因广泛的老年ED患者（n = 411），以及（ii）患有ED和糖尿病的老年患者（n = 71）。使用总体疗效问题、国际勃起功能指数（IIEF）的问题3和问题4以及IIEF的五个性功能领域来评估疗效。
所有疗效评估均表明，西地那非在病因广泛的老年ED患者以及患有ED和糖尿病的老年患者中均显著改善了勃起功能。最常见的不良事件是轻度至中度头痛、潮红和消化不良。因不良事件停药的发生率较低，且与安慰剂组相当。
西地那非是治疗老年男性ED的一种有效且耐受性良好的药物。
