Department of Urology, Ankara University School of Medicine, Adnan Saygun Caddesi, Altındağ, Ankara, Turkey.
Int Urol Nephrol. 2012 Jun;44(3):683-7. doi: 10.1007/s11255-012-0126-z. Epub 2012 Jan 18.
Erectile dysfunction (ED) is a common problem for elderly males. Higher serum lipid levels have important role in the pathogenesis, and in this prospective randomized trial, it is aimed to identify the effect of atorvastatin on erectile functions in comparison with regular tadalafil use.
120 patients with a minimum 3-months history of moderate-to-severe ED were involved. The patients were randomized to receive atorvastatin 10 mg/day, tadalafil 20 mg 3 times/week or no medication. Baseline serum testosterone, lipid levels IEEF and NPT test were performed and repeated after 3 months of treatment, and the 3 groups were compared.
Mean age of the whole population was 56 years (31-70). The 3 groups were well balanced for the baseline characteristics. Mean improvement of IIEF score was significantly higher in tadalafil group compared to atorvastatin (P = 0.01) and control group (P = 0.0001). Also atorvastatin showed significantly better improvement compared to control group (P = 0.001). Positive NPT test results in tadalafil group was significantly higher than atorvastatin group (25/40 (62.5%) vs. 16/41 (39%), P = 0.003) and compared to control group (25/40 (62.5%) vs. 3/39 (7.6%), P = 0.0001). At the same time, the difference between group 1 and group 3 was statistically significant (P = 0.001).
Tadalafil 20 mg three times/week shows better results than 10 mg atorvastatin daily. Atorvastatin alone seems to improve EF compared to not using any medication, and this significance is more prominent in patients with supranormal serum lipid levels. Further studies with subgroups of different serum lipid levels should be conducted.
勃起功能障碍(ED)是老年男性的常见问题。较高的血清脂质水平在发病机制中具有重要作用,在这项前瞻性随机试验中,旨在确定阿托伐他汀与常规他达拉非使用相比对勃起功能的影响。
共纳入 120 例至少有 3 个月中重度 ED 病史的患者。患者随机分为阿托伐他汀 10 mg/天、他达拉非 20 mg 每周 3 次或不服用药物。进行基线血清睾酮、脂质水平 IIEF 和 NPT 测试,并在治疗 3 个月后重复测试,并对 3 组进行比较。
整个人群的平均年龄为 56 岁(31-70 岁)。3 组在基线特征方面平衡良好。与阿托伐他汀组(P = 0.01)和对照组(P = 0.0001)相比,他达拉非组 IIEF 评分的平均改善显著更高。与对照组相比,阿托伐他汀组的改善也明显更好(P = 0.001)。他达拉非组的阳性 NPT 测试结果显著高于阿托伐他汀组(25/40(62.5%)比 16/41(39%),P = 0.003)和对照组(25/40(62.5%)比 3/39(7.6%),P = 0.0001)。同时,组 1 和组 3 之间的差异具有统计学意义(P = 0.001)。
每周 3 次 20 mg 他达拉非的效果优于每日 10 mg 阿托伐他汀。阿托伐他汀单独使用似乎比不服用任何药物更能改善 EF,而且在血清脂质水平高于正常值的患者中,这种作用更为明显。应进行具有不同血清脂质水平亚组的进一步研究。