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阿伐那非治疗男性勃起功能障碍的疗效与安全性:随机对照试验的系统评价与荟萃分析

The Efficacy and Safety of Avanafil During a Treatment of Male Erectile Dysfunction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

作者信息

Warli Syah Mirsya, Steven Steven, Kadar Dhirajaya Dharma, Prapiska Fauriski Febrian, Siregar Ginanda Putra

机构信息

Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara - Haji Adam Malik General Hospital, Medan, Indonesia.

Department of Urology, Universitas Sumatera Utara Hospital, Universitas Sumatera Utara, Medan, Indonesia.

出版信息

Ther Clin Risk Manag. 2023 Jul 18;19:629-644. doi: 10.2147/TCRM.S419408. eCollection 2023.

Abstract

PURPOSE

Erectile dysfunction (ED) contributes to a large burden and impairs the quality of life among males. Avanafil appears to be a promising treatment for ED; however, its efficacy and safety profile remain unclear. This study aimed to evaluate the efficacy and safety of avanafil for the treatment of ED.

PATIENTS AND METHODS

An extensive search of PubMed, ScienceDirect, Web of Science, and Embase databases with 11 publications was performed, with outcomes evaluated are International Index of Erectile Function - Erectile Function (IIEF-EF), Sexual Encounter Profile (SEP), and Treatment-Emergent Adverse Events (TEAE). Statistical parameter Mean Difference (MD) and Risk Ratio (RR) with 95% Confidence Interval (CI) were used to measure effect size.

RESULTS

The pooled estimates demonstrated that changes in IIEF-EF function (MD=4.39, 95% CI [3.41, 5.37], p<0.001), SEP-2 (RR=3.43, 95% CI [2.79, 4.22], p<0.001), SEP-3 (RR=2.30, 95% CI [2.01, 2.62], p<0.001), and TEAE (RR=1.49, 95% CI [1.12, 1.96], p=0.005) were significantly higher in the avanafil group than in the placebo group. Moreover, 200 mg avanafil was superior to that mg 100 mg-avanafil, indicated by the IIEF-EF score (MD=-1.15, 95% CI [-1.40, -0.89], p<0.001). In contrary, there were no significant differences in SEP-2 (RR=0.90, 95% CI [0.75, 1.08], p=0.26), SEP-3 (RR=0.92, 95% CI [0.81, 1.05], p=0.21) and TEAE (RR=1.00, 95% CI [0.87, 1.15], p=0.99) for both 100 mg and 200 mg doses.

CONCLUSION

This review highlights the potential use of this drug in ED treatment. Further large-scale Randomized Controlled Trials investigations involving various racial groups are required to confirm these findings.

摘要

目的

勃起功能障碍(ED)给男性带来了沉重负担,损害了他们的生活质量。阿伐那非似乎是一种有前景的ED治疗药物;然而,其疗效和安全性仍不明确。本研究旨在评估阿伐那非治疗ED的疗效和安全性。

患者与方法

对PubMed、ScienceDirect、Web of Science和Embase数据库进行广泛检索,共纳入11篇文献,评估的结果指标包括国际勃起功能指数-勃起功能(IIEF-EF)、性活动记录(SEP)和治疗中出现的不良事件(TEAE)。采用统计参数平均差(MD)和风险比(RR)及95%置信区间(CI)来衡量效应大小。

结果

汇总估计表明,阿伐那非组在IIEF-EF功能变化(MD = 4.39,95% CI [3.41, 5.37],p < 0.001)、SEP-2(RR = 3.43,95% CI [2.79, 4.22],p < 0.001)、SEP-3(RR = 2.30,95% CI [2.01, 2.62],p < 0.001)和TEAE(RR = 1.49,95% CI [1.12, 1.96],p = 0.005)方面显著高于安慰剂组。此外,根据IIEF-EF评分,200 mg阿伐那非优于100 mg阿伐那非(MD = -1.15,95% CI [-1.40, -0.89],p < 0.001)。相反,100 mg和200 mg剂量在SEP-2(RR = 0.90,95% CI [0.75, 1.08],p = 0.26)、SEP-3(RR = 0.92,95% CI [0.81, 1.05],p = 0.21)和TEAE(RR = 1.00,95% CI [0.87, 1.15],p = 0.99)方面无显著差异。

结论

本综述强调了该药物在ED治疗中的潜在应用。需要进一步开展涉及不同种族群体的大规模随机对照试验来证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c568/10362898/56ee95326fe8/TCRM-19-629-g0001.jpg

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