Comparing PDE-5 Inhibitors in the Same Population.

Comparing PDE-5 Inhibitors in the Same Population, Aksam A. Yassin, Clinic of Urology/Andrology, Germany, and Gulf Medical College School of Medicine, UAE; Farid Saad, SBU Andrology, Male Health Care, Schering AG, Germany, and Gulf Medical College School of Medicine, UAE

This independent prospective, cross-over, observational, and open-label study assessed efficacy, patients' preference, and the side-effect profile of sildenafil, tadalafil, and vardenafil in the same population. During June 2003 and June 2004, 641 patients were recruited to be treated in three equal groups in 4-month cycles with sildenafil, 25, 50, or 100 mg; tadalafil, 10 or 20 mg; and vardenafil, 10 or 20 mg. We assessed the onset of efficacy in minutes after intake, IIEE side-effect profile, and partner satisfaction. Etiology of ED was psychogenic or of different organic geneses, including diabetes. True responders were investigated by means of a partner assessment questionnaire. After deducting 19 dropouts and 37 non-evaluated patients who did not complete the study, 585 subjects could be properly evaluated. The onset of vardenafil was the fastest, about 5-17 minutes. Fastest flooding of the plasma level was reached by vardenafil 20 mg, followed by sildenafil and tadalafil. Overall satisfaction was approximately the same in all three of the substances, with more approval for sildenafil, possibly due to economic reasons, as it's easier to divide. The decision of younger patients (less than 55 years) was in favor of tadalafil. Diabetics (114 patients) plainly preferred vardenafil. The partner assessment of true responders showed an overall satisfaction with sildenfil, tadalafil, and vardenafil. In terms of efficacy and contentment, all 3 substances did equally well. The preferences varied between economic (sildenafil, which is easy to divide in 2 or 4 pieces) and speed of onset and penile rigidity (vardenafil). An age-dependent preference in young patients was remarkable. Those between 40 and 55 preferred tadalafil, probably due to its longer elimination time.