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EDEUS:一项关于5型磷酸二酯酶抑制剂使用者的真实生活研究——聚焦第二代阿伐那非的欧洲男性的患病率、认知及就医行为

EDEUS, a Real-Life Study on the Users of Phosphodiesterase Type 5 Inhibitors: Prevalence, Perceptions, and Health Care-Seeking Behavior Among European Men With a Focus on 2nd-Generation Avanafil.

作者信息

Corona Giovanni, Maggi Mario, Jannini Emmanuele A

机构信息

Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Azienda-Usl Bologna, Bologna, Italy; Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy.

Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy.

出版信息

Sex Med. 2018 Mar;6(1):15-23. doi: 10.1016/j.esxm.2017.10.003. Epub 2017 Dec 21.

Abstract

INTRODUCTION

Erectile dysfunction (ED) is a multidimensional disorder with an estimated prevalence of 1% to 10% in men younger than 40 years and up to 100% in men in their 70s and 80s.

AIM

To evaluate the real-life characteristics and unmet needs of men with ED, its impact on well-being, and treatment rates across Europe.

METHODS

Adult men in Belgium, France, Germany, Italy, Poland, Portugal, and Spain were invited to participate in the survey. Men who did not use at least a drug for sexual health in the past 3 months, had cancer or spinal cord injuries, and/or underwent non-nerve-sparing radical prostatectomy were excluded.

MAIN OUTCOME MEASURES

The 15-item International Index of Erectile Function (IIEF-15) with study-specific, self-constructed questions was used.

RESULTS

Overall, 940 subjects (age = 46.2 ± 13.4 years) were considered. Subjects (n = 778) using on-demand phosphodiesterase type 5 inhibitors (PDE5is) were designated "performers" (60%) without a formal ED diagnosis or "patients" with a medical diagnosis. Patients were older than performers, with more self-reported comorbidities; patients used a higher PDE5i dosage and purchased it from official pharmacies more often than performers did. Of avanafil users (n = 39), no differences in total IIEF or subdomain scores were observed after adjusting for confounders. However, avanafil users less often declared its use without an ED diagnosis and a physician prescription. Overall, the latter condition was associated with higher PDE5i-related satisfaction.

CONCLUSION

The survey shows 2 different attitudes toward ED and PDE5i use: for recreational use and without a medical prescription or with a formal diagnosis and medical prescription. Avanafil, a 2nd-generation PDE5i with a good balance between efficacy and tolerability profile, is more frequently prescribed by doctors than self-prescribed compared with other PDE5is. Because the major challenge is to decrease the high dropout of 1st-generation PDE5is, further studies will be needed to clarify this topic. Corona G, Maggi M, Jannini EA. EDEUS, a Real-Life Study on the Users of Phosphodiesterase Type 5 Inhibitors: Prevalence, Perceptions, and Health Care-Seeking Behavior Among European Men With a Focus on 2nd-Generation Avanafil. Sex Med 2018;6:15-23.

摘要

引言

勃起功能障碍(ED)是一种多维度疾病,据估计,40岁以下男性的患病率为1%至10%,70多岁和80多岁男性的患病率高达100%。

目的

评估欧洲勃起功能障碍男性的现实生活特征和未满足的需求、其对幸福感的影响以及治疗率。

方法

邀请比利时、法国、德国、意大利、波兰、葡萄牙和西班牙的成年男性参与调查。排除过去3个月内未使用至少一种性健康药物、患有癌症或脊髓损伤以及/或接受了非保留神经的根治性前列腺切除术的男性。

主要观察指标

使用特定研究自行构建问题的15项国际勃起功能指数(IIEF-15)。

结果

总体而言,共纳入940名受试者(年龄 = 46.2 ± 13.4岁)。使用按需服用5型磷酸二酯酶抑制剂(PDE5is)的受试者(n = 778)被指定为“使用者”(60%),他们没有正式的勃起功能障碍诊断,或被指定为有医学诊断的“患者”。患者比使用者年龄更大,自我报告的合并症更多;患者使用的PDE5i剂量更高,且比使用者更常从官方药店购买。在对混杂因素进行调整后,阿伐那非使用者(n = 39)在IIEF总分或各子领域得分方面未观察到差异。然而,阿伐那非使用者较少宣称在没有勃起功能障碍诊断和医生处方的情况下使用该药物。总体而言,后一种情况与更高的PDE5i相关满意度相关。

结论

该调查显示了对勃起功能障碍和使用PDE5is的两种不同态度:用于娱乐目的且无医学处方,或有正式诊断和医学处方。与其他PDE5is相比,阿伐那非作为第二代PDE5i,在疗效和耐受性之间具有良好平衡,医生开具处方的频率高于自我用药。由于主要挑战是降低第一代PDE5is的高停药率,因此需要进一步研究来阐明这一主题。科罗纳G、马吉M、詹尼尼EA。EDEUS,一项关于5型磷酸二酯酶抑制剂使用者的现实生活研究:欧洲男性中阿伐那非第二代使用者的患病率、认知及医疗寻求行为。性医学2018;6:15 - 23。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c65/5815971/e548c3240e4c/gr1.jpg

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