Cairoli Carlos, Reyes Luis Antonio, Henneges Carsten, Sorsaburu Sebastian
Hospital Sao Lucas, Pontifical Catholic University of Rio Grande do Sul (HSL-PUCRS), RS, Brazil.
Eli Lilly and Company, Mexico City, Mexico.
Int Braz J Urol. 2014 May-Jun;40(3):390-9. doi: 10.1590/S1677-5538.IBJU.2014.03.14.
Characterize persistence and adherence to phosphodiesterase type - 5 inhibitor (PDE5I) on-demand therapy over 6 months among Brazilian men in an observational, non-interventional study of Latin American men naïve to PDE5Is with erectile dysfunction (ED).
Men were prescribed PDE5Is per routine clinical practice. Persistence was defined as using ≥ 1 dose during the previous 4 - weeks, and adherence as following dosing instructions for the most recent dose, assessed using the Persistence and Adherence Questionnaire. Other measures included the Self - Esteem and Relationship (SEAR) Questionnaire, and International Index of Erectile Function (IIEF). Multivariate logistic regression was used to identify factors associated with persistence/adherence.
104 Brazilian men were enrolled; mean age by treatment was 53 to 59 years, and most presented with moderate ED (61.7%). The prescribed PDE5I was sildenafil citrate for 50 (48.1%), tadalafil for 36 (34.6%), vardenafil for 15 (14.4%), and lodenafil for 3 patients (2.9%). Overall treatment persistence was 69.2% and adherence was 70.2%; both were numerically higher with tadalafil (75.0%) versus sildenafil or vardenafil (range 60.0% to 68.0%). Potential associations of persistence and/or adherence were observed with education level, ED etiology, employment status, and coronary artery disease. Improvements in all IIEF domain scores, and both SEAR domain scores were observed for all treatments. Study limitations included the observational design, brief duration, dependence on patient self - reporting, and limited sample size.
Approximately two-thirds of PDE5I-naive, Brazilian men with ED were treatment persistent and adherent after 6 months. Further study is warranted to improve long-term outcomes of ED treatment.
在一项针对拉丁美洲初治磷酸二酯酶5型抑制剂（PDE5I）且患有勃起功能障碍（ED）的男性的观察性、非干预性研究中，对巴西男性6个月按需使用PDE5I治疗的持续性和依从性进行特征描述。
按照常规临床实践为男性开具PDE5I。持续性定义为在前4周内使用≥1剂，依从性定义为遵循最近一剂的给药说明，使用持续性和依从性问卷进行评估。其他测量指标包括自尊与关系（SEAR）问卷和国际勃起功能指数（IIEF）。采用多因素逻辑回归来确定与持续性/依从性相关的因素。
纳入104名巴西男性；按治疗分组的平均年龄为53至59岁，大多数表现为中度ED（61.7%）。开具的PDE5I中，枸橼酸西地那非50例（48.1%），他达拉非36例（34.6%），伐地那非15例（14.4%），洛地那非3例（2.9%）。总体治疗持续性为69.2%，依从性为70.2%；他达拉非组（75.0%）的持续性和依从性在数值上均高于西地那非或伐地那非组（范围为60.0%至68.0%）。观察到持续性和/或依从性与教育水平、ED病因、就业状况和冠状动脉疾病之间可能存在关联。所有治疗组的IIEF各领域得分以及SEAR各领域得分均有改善。研究局限性包括观察性设计、疗程较短、依赖患者自我报告以及样本量有限。
约三分之二初治PDE5I的巴西ED男性在6个月后治疗具有持续性且依从。有必要进一步研究以改善ED治疗的长期效果。
