Gong Binbin, Ma Ming, Xie Wenjie, Yang Xiaorong, Huang Yongming, Sun Ting, Luo Yanping, Huang Jiao
Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, 330000, Jiangxi Province, China.
Int Urol Nephrol. 2017 Oct;49(10):1731-1740. doi: 10.1007/s11255-017-1644-5. Epub 2017 Jul 24.
Erectile dysfunction (ED) is a major care problem worldwide. Tadalafil and sildenafil are the two most common phosphodiesterase 5 inhibitors used to treat ED. This systematic review and meta-analysis were conducted to directly compare tadalafil with sildenafil for the treatment of ED.
We designed a strategy for searching the PubMed, Embase, EBSCO, Web of Science and Cochrane library databases; the reference lists of the retrieved studies were also investigated. A literature review was performed to identify all published randomized or non-randomized controlled trials that compared tadalafil with sildenafil for the treatment of ED and to assess the quality of the studies. Two investigators independently and blindly screened the studies for inclusion. The meta-analysis was performed using RevMan 5.0.
A total of 16 trials that compared tadalafil with sildenafil for the treatment of ED were included in the meta-analysis. In the meta-analysis, tadalafil and sildenafil appeared to have similar efficacies and overall adverse event rates. However, compared with sildenafil, tadalafil significantly improved psychological outcomes. Furthermore, the patients and their partners preferred tadalafil over sildenafil, and no significant difference was found in the adherence and persistence rates between tadalafil and sildenafil. Additionally, the myalgia and back pain rates were higher and the flushing rate was lower with tadalafil than with sildenafil.
Tadalafil shares a similar efficacy and safety with sildenafil and significantly improves patients' sexual confidence. Furthermore, patients and their partners prefer tadalafil to sildenafil. Hence, tadalafil may be a better choice for ED treatment.
勃起功能障碍（ED）是全球范围内的一个主要医疗问题。他达拉非和西地那非是用于治疗ED的两种最常见的磷酸二酯酶5抑制剂。进行这项系统评价和荟萃分析以直接比较他达拉非与西地那非治疗ED的效果。
我们设计了一种检索PubMed、Embase、EBSCO、科学网和Cochrane图书馆数据库的策略；还对检索到的研究的参考文献列表进行了调查。进行文献综述以识别所有已发表的比较他达拉非与西地那非治疗ED的随机或非随机对照试验，并评估研究质量。两名研究者独立且盲法筛选纳入研究。使用RevMan 5.0进行荟萃分析。
荟萃分析共纳入16项比较他达拉非与西地那非治疗ED的试验。在荟萃分析中，他达拉非和西地那非似乎具有相似的疗效和总体不良事件发生率。然而，与西地那非相比，他达拉非显著改善了心理结局。此外，患者及其伴侣更喜欢他达拉非而非西地那非，他达拉非与西地那非在依从率和持续率方面未发现显著差异。此外，他达拉非的肌痛和背痛发生率高于西地那非，潮红发生率低于西地那非。
他达拉非与西地那非具有相似的疗效和安全性，并显著提高患者的性信心。此外，患者及其伴侣更喜欢他达拉非而非西地那非。因此，他达拉非可能是治疗ED的更好选择。
