Department of Urology, University of Freiburg, Freiburg, Germany.
Department of Urology, University of Munich, Munich, Germany.
Eur Urol Focus. 2022 May;8(3):794-802. doi: 10.1016/j.euf.2021.04.019. Epub 2021 May 15.
Erectile dysfunction (ED) is a major care problem worldwide. Tadalafil and sildenafil are the two most common phosphodiesterase-5 inhibitors (PDE5is) used to treat ED.
This study aimed to evaluate patient data of a large online prescription platform (OPP), specifically analyzing preference for tadalafil over sildenafil.
DESIGN, SETTING, AND PARTICIPANTS: Data from a prospectively collected German OPP were retrospectively analyzed. This dataset included patients with a history of taking one or both substances (n = 26 821).
ED patient baseline characteristics were derived from medical questionnaires for PDE5i prescriptions between May 2019 and May 2020. Order behavior was analyzed in patients who ordered both substances over time. We applied Kruskal-Wallis tests, χ² tests, and fisher's exact tests for statistical analysis.
Baseline characteristics were comparable for both PDE5is in patients with a median age of 49 yr (sildenafil [interquartile range {IQR} 38-57]; tadalafil [IQR 39-56]), a median body mass index (BMI) of 26 kg/m² (sildenafil [IQR 24.54-29.03]; tadalafil [IQR 24.49-28.69]), ED onset time of >12 mo (sildenafil [87%]; tadalafil [88%]), and the presence of morning erections (sildenafil [62%]; tadalafil [61%]). Tadalafil prescriptions increased significantly from 30% (first order) to 80% (last order) in patients who had already tested both drugs. Patients with age ≤40 yr, BMI ≤25 kg/m², and sustained morning erections preferred tadalafil to sildenafil.
Using database information from an OPP, preference for tadalafil was shown for patients who had tested both PDE5is. This preference was particularly pronounced in patients with age ≤40 yr, BMI ≤25 kg/m², and sustained morning erections. A well-managed OPP can be used for research on more complex health services.
Analysis of large online prescription platforms provide the benefit of identifying young treatment-naïve patients with early-stage disease, which is highlighted by the fact that about two-thirds of our patients analyzed still maintained spontaneous morning erections. Patients who had tested tadalafil once developed preference for this drug.
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两种最常用于治疗 ED 的磷酸二酯酶 5 抑制剂（PDE5i）。
本研究旨在评估大型在线处方平台（OPP）的患者数据，特别是分析患者对他达拉非的偏好。
设计、地点和参与者：回顾性分析了前瞻性收集的德国 OPP 的数据。该数据集包括有服用一种或两种药物史的患者（n=26821）。
ED 患者的基线特征来自于 2019 年 5 月至 2020 年 5 月期间 PDE5i 处方的医学问卷。对随着时间推移同时服用这两种药物的患者的用药行为进行了分析。我们应用了 Kruskal-Wallis 检验、卡方检验和 Fisher 精确检验进行统计分析。
在中位年龄为 49 岁（西地那非[四分位距{IQR}38-57]；他达拉非[IQR 39-56]）、中位体重指数（BMI）为 26kg/m²（西地那非[IQR 24.54-29.03]；他达拉非[IQR 24.49-28.69]）、ED 发病时间>12 个月（西地那非[87%]；他达拉非[88%]）和存在晨勃（西地那非[62%]；他达拉非[61%]的患者中，两种 PDE5i 的基线特征具有可比性。在已经测试过两种药物的患者中，他达拉非的处方量从 30%（首次处方）显著增加到 80%（最后一次处方）。年龄≤40 岁、BMI≤25kg/m² 和持续晨勃的患者更喜欢他达拉非。
使用 OPP 的数据库信息，我们发现曾测试过两种 PDE5i 的患者更倾向于使用他达拉非。这种偏好尤其在年龄≤40 岁、BMI≤25kg/m² 和持续晨勃的患者中更为明显。管理良好的 OPP 可用于更复杂的医疗服务研究。
对大型在线处方平台的分析有助于确定年轻的、初治的早期疾病患者，我们分析的患者中约有三分之二仍有自发性晨勃，这一点突出了这一点。曾服用过他达拉非的患者会对这种药物产生偏好。
