McVary Kevin T, Siegel Richard L, Carlsson Martin
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611-3008, USA.
Urology. 2008 Sep;72(3):575-9. doi: 10.1016/j.urology.2008.04.020. Epub 2008 Jul 2.
To evaluate the body mass index (BMI) and lower urinary tract symptom (LUTS) severity on treatment response to sildenafil in men with erectile dysfunction (ED) and moderate to severe LUTS associated with benign prostatic hyperplasia.
A post hoc analysis of data from a 12-week, double-blind, placebo-controlled study of sildenafil (50 mg once daily titrated to 100 mg once daily) was conducted. The BMI categories were obese (> or = 30 kg/m(2)), overweight (> or = 25 to < 30 kg/m(2)), and normal weight (< 25 kg/m(2)). ED was defined as a score of < or = 25 on the erectile function domain of the International Index of Erectile Function, and LUTS was defined by an International Prostate Symptom Score of > or = 12. The maximal urinary flow rate was determined by uroflowmetry.
Patients receiving sildenafil (n = 189) had a significant improvement in the erectile function domain scores of the International Index of Erectile Function (P < .0001 vs placebo, n = 180), which did not vary across BMI groups. A greater improvement in LUTS score was observed with sildenafil compared with placebo for men with severe LUTS (-8.6 vs -2.4, P < .0001) than in men with moderate LUTS (-3.6 vs -1.7, P = .06). Also, the improvement in LUTS scores was significant (P < or = .02) for men taking sildenafil independent of BMI (obese, -8.9 vs -5.4; overweight, -7.3 vs -3.2; normal weight, -7.1 vs -0.84). No difference was found among the treatment groups in the change from baseline maximal urinary flow rate across all LUTS and BMI categories (range 4.5 to -4.2 mL/s).
The results of our study have shown that daily dosing with sildenafil improved ED and LUTS independent of baseline LUTS severity or BMI.
评估体重指数(BMI)和下尿路症状(LUTS)严重程度对伴有勃起功能障碍(ED)及与良性前列腺增生相关的中度至重度LUTS的男性使用西地那非治疗反应的影响。
对一项为期12周的西地那非(50毫克每日一次滴定至100毫克每日一次)双盲、安慰剂对照研究的数据进行事后分析。BMI类别分为肥胖(≥30千克/米²)、超重(≥25至<30千克/米²)和正常体重(<25千克/米²)。ED定义为国际勃起功能指数勃起功能领域得分≤25分,LUTS由国际前列腺症状评分≥12分定义。通过尿流率测定法确定最大尿流率。
接受西地那非治疗的患者(n = 189)在国际勃起功能指数勃起功能领域得分有显著改善(与安慰剂组相比,n = 180,P <.0001),且在各BMI组间无差异。与安慰剂相比,西地那非治疗重度LUTS男性的LUTS评分改善更大(-8.6对-2.4,P <.0001),而中度LUTS男性改善较小(-3.6对-1.7,P =.06)。此外,服用西地那非的男性LUTS评分改善显著(P≤.02),与BMI无关(肥胖,-8.9对-5.4;超重,-7.3对-3.2;正常体重,-7.1对- .84)。在所有LUTS和BMI类别中,各治疗组从基线最大尿流率的变化无差异(范围4.5至-4.2毫升/秒)。
我们的研究结果表明,每日服用西地那非可改善ED和LUTS,与基线LUTS严重程度或BMI无关。