Miner Martin, Gilderman Larry, Bailen James, Cook David, Dawson Katie, Stanislaus Marisha, Beresford Eric, Barnes Allison
Clinical Associate Professor of Family Medicine, Brown University School of Medicine, Swansea, MA, USA.
J Sex Med. 2008 Jun;5(6):1455-67. doi: 10.1111/j.1743-6109.2008.00820.x. Epub 2008 Mar 26.
Phosphodiesterase type-5 (PDE-5) inhibitors have previously been evaluated for their efficacy and safety in various clinical trials in men with erectile dysfunction (ED) with or without associated comorbidities.
This is the first prospective, randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of a PDE-5 inhibitor (i.e., vardenafil) in an exclusive population of men with ED and dyslipidemia.
Three coprimary efficacy measurements (Sexual Encounter Performance [SEP]2, SEP3, International Index of Erectile Function-Erectile Function [IIEF-EF] domain scores) were used to assess the differential effect of vardenafil vs. placebo in this patient population. Adverse events (AEs) safety data were obtained to compare safety outcomes.
This 12-week of randomized, double-blind, placebo-controlled study was conducted in 59 U.S. centers. Patients received either on-demand, flexible-dose vardenafil 10 mg (titrated to 5 mg or 20 mg based upon efficacy and safety) or placebo.
Of the 712 patients screened and entered into the study, 395 were randomized. Baseline demographics for the intent-to-treat population included: mean age, 54.4 years (+/-7.5 standard deviation [SD]); 76% Caucasian; mean body mass index (BMI), 31.7 kg/m(2) (+/-12.7 SD); 47% past/present smoker; and 42% severe ED. Aside from dyslipidemia, other comorbidities included hypertension, 61%; obesity (i.e., BMI >/= 30), 51%; and type 1 or 2 diabetes, 40%. During the 12-week treatment period, the least squares (LS) adjusted mean success rates in patients on vardenafil vs. placebo were: SEP2, 79.09% vs. 51.92%; and SEP3, 66.69% vs. 33.83% (P < 0.001). The LS adjusted mean IIEF-EF domain score for week 12 using LOCF was 21.99 in patients on vardenafil therapy vs. 14.83 in those on placebo (P < 0.001). The most commonly encountered AEs were headache and nasal congestion.
Vardenafil was demonstrated to be safe and effective for managing ED in men with ED and associated dyslipidemia. The results of this study support the role of expanded research on outcomes related to effective ED treatment and aggressive lipid control.
磷酸二酯酶5型(PDE - 5)抑制剂此前已在各种临床试验中对患有或未患有相关合并症的勃起功能障碍(ED)男性的疗效和安全性进行了评估。
这是第一项前瞻性、随机、双盲、安慰剂对照研究,旨在评估PDE - 5抑制剂(即伐地那非)在患有ED和血脂异常的男性特定人群中的疗效和安全性。
采用三项共同主要疗效指标(性接触成功率[SEP]2、SEP3、国际勃起功能指数 - 勃起功能[IIEF - EF]领域评分)来评估伐地那非与安慰剂在该患者群体中的差异效应。获取不良事件(AE)安全数据以比较安全性结果。
这项为期12周的随机、双盲、安慰剂对照研究在美国的59个中心进行。患者按需接受灵活剂量的伐地那非10毫克(根据疗效和安全性调整为5毫克或20毫克)或安慰剂。
在筛选并进入研究的712例患者中,395例被随机分组。意向性治疗人群的基线人口统计学特征包括:平均年龄54.4岁(±7.5标准差[SD]);76%为白种人;平均体重指数(BMI)为31.7kg/m²(±12.7SD);47%有过去/现在吸烟史;42%为重度ED。除血脂异常外,其他合并症包括高血压,占61%;肥胖(即BMI≥30),占51%;1型或2型糖尿病,占40%。在12周的治疗期内,伐地那非组与安慰剂组患者经最小二乘法(LS)调整后的平均成功率分别为:SEP2,79.09%对51.92%;SEP3,66.69%对33.83%(P<0.001)。使用末次观察结转(LOCF)法得出的第12周LS调整后平均IIEF - EF领域评分,伐地那非治疗组患者为21.99,安慰剂组患者为14.83(P<0.001)。最常出现的不良事件为头痛和鼻充血。
伐地那非被证明对患有ED及相关血脂异常的男性治疗ED安全有效。本研究结果支持对与有效治疗ED和积极控制血脂相关的结局进行进一步研究。