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伐地那非治疗高血压男性勃起功能障碍的疗效:临床试验数据的荟萃分析

Efficacy of vardenafil for the treatment of erectile dysfunction in men with hypertension: a meta-analysis of clinical trial data.

作者信息

Shabsigh Ridwan, Duval Sue, Shah Manan, Regan Timothy S, Juhasz Marta, Veltry Lauren G

机构信息

Columbia University, New York, NY, USA.

出版信息

Curr Med Res Opin. 2007 Oct;23(10):2453-60. doi: 10.1185/030079907X219616.

Abstract

OBJECTIVE

To review the evidence evaluating the efficacy of vardenafil in subgroups of hypertensive patients with erectile dysfunction (ED).

METHODS

Meta-analysis of randomized, double-blinded, placebo-controlled, flexible-dose vardenafil clinical trials that were >or=12 weeks in duration evaluated men with a >or=6-month history of ED and required a >or=50% failure rate in baseline sexual attempts. The primary endpoints analyzed were the erectile function domain of the International Index of Erectile Function questionnaire (IIEF-EF) and Sexual Encounter Profile questions 2 (SEP2) and 3 (SEP3).

RESULTS

Eight clinical trials were included (n = 2427 patients) consisting of 839 patients (35%) with a self-reported diagnosis of hypertension (HTN): 498 in the vardenafil and 341 in the placebo groups. Vardenafil's efficacy was evidenced by an average increase of 8.9 points in the IIEF-EF (95% CI: 7.4, 10.5) at week 12 compared to placebo, with individual trial values ranging from 16.4 to 26.1 and 11.3 to 17.8 for the vardenafil and placebo groups, respectively. Vardenafil also increased success rates for the ability to obtain erections (SEP2) by 32.4% (95% CI: 27.4%, 37.5%) over a 12-week timeframe compared to placebo, with individual trial values ranging from 57.2% to 92.2% for vardenafil and 32.0% to 66.9% for placebo. Similarly, success rates for the ability to maintain erections (SEP3) improved 38.0% (95% CI: 29.5%, 46.6%) compared to placebo, with individual trial values ranging from 41.7% to 88.2% for vardenafil and 20.5% to 51.4% for placebo. Vardenafil was equally efficacious in improving IIEF-EF, SEP2, and SEP3 in those with and without self-reported HTN.

CONCLUSION

This meta-analysis demonstrated that vardenafil was significantly more efficacious than placebo for the treatment of ED in patients with comorbid HTN and offered similar treatment benefits in patients without HTN.

摘要

目的

回顾评估伐地那非对勃起功能障碍(ED)高血压患者亚组疗效的证据。

方法

对持续时间≥12周的随机、双盲、安慰剂对照、灵活剂量伐地那非临床试验进行荟萃分析,评估有≥6个月ED病史且基线性尝试失败率≥50%的男性。分析的主要终点是国际勃起功能指数问卷(IIEF-EF)的勃起功能领域以及性接触概况问题2(SEP2)和3(SEP3)。

结果

纳入8项临床试验(n = 2427例患者),其中839例(35%)自述诊断为高血压(HTN):伐地那非组498例,安慰剂组341例。与安慰剂相比,伐地那非在第12周时IIEF-EF平均增加8.9分(95%CI:7.4,10.5),证明了其疗效,伐地那非组和安慰剂组的各试验个体值分别为16.4至26.1和11.3至17.8。与安慰剂相比,伐地那非在12周时间内使勃起能力(SEP2)成功率提高32.4%(95%CI:27.4%,37.5%),伐地那非组和安慰剂组的各试验个体值分别为57.2%至92.2%和32.0%至66.9%。同样,与安慰剂相比,维持勃起能力(SEP3)成功率提高38.0%(95%CI:29.5%,46.6%),伐地那非组和安慰剂组的各试验个体值分别为41.7%至88.2%和20.5%至51.4%。伐地那非在改善自述有或无HTN患者的IIEF-EF、SEP2和SEP3方面同样有效。

结论

这项荟萃分析表明,伐地那非治疗合并HTN的ED患者比安慰剂显著更有效,且对无HTN的患者提供相似治疗益处。

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