SILDENAFIL EFFECTIVE EVEN FOR MEN WITH THE MOST SEVERE CASES OF ERECTILE DYSFUNCTION
Title: SILDENAFIL EFFECTIVE EVEN FOR MEN WITH THE MOST SEVERE CASES OF ERECTILE DYSFUNCTION , Modern Medicine, 00268070, Jul98, Vol. 66, Issue 7
Section: meeting abstracts: UROLOGY MEETING
Sildenafil citrate (Viagra) produces some degree of firmness in up to 80% of men with erectile dysfunction of broad-spectrum etiology and in up to 50% of those with the most severe form of impotence –that is, those who never or almost never attain an erection, according to a new clinical trial and a meta-analysis:
CLINICAL TRIAL. Harin Padma-Nathan, MD, presented the results of the largest U.S. trial to date. (His study also appears in the May 14 issue of The New England Journal of Medicine [1998;338:1397-404].) This 6-month, multicenter, safety and efficacy study involved 532 men (mean age: 58) with erectile dysfunction who were randomized to one of four cohorts. One group took placebo, and the others took 25, 50, or 100 mg of sildenafil.
The researchers assessed the frequency of penetration and the frequency of maintained erections at 12 and 24 weeks with a log that patients kept called the International Index of Erectile Function and by simply asking the men if treatment improved their erections. Responses were graded on a scale of 1 (never or almost never) to 5 (always or almost always). The results indicated a clear dose-response effect
At 6 months, 56% of the men who took 25 mg of sildenafil had a mean score of 3.19 for frequency of penetration. This indicates that the men obtained erections sufficient for sex on better than half of their attempts.
The mean score for the frequency of maintained erections in the 25-mg group was 4.02, indicating that the drug helped the men achieve and maintain tumescence in well over two-thirds of their attempts.
In the 50-mg group, the respective scores were 3.51 and 3.49.
In the 100-mg group, scores were 4.02 and 3.93.
Placebo scores were 2.24 and 2.11.
META-ANALYSIS. William Steers, MD, and colleagues looked at sildenafil’s effects in men who had the most severe forms of dysfunction.
They culled data from 10 studies involving a total of 3,361 men. Subjects took either placebo or 50 or 100 mg of sildenafil. Once again, efficacy was assessed by the frequency of penetration and frequency of maintained erection.
Some 46% of the men achieved a mean score of at least 4 for frequency of penetration, and 48% had a score of at least 4 for frequency of maintained erection. Only 8% of the controls scored 4 or higher in both of these areas.
“The take-home message,” says Steers, “is that even in the most severe cases, sildenafil works in almost half the cases.”
Dr. Padma-Nathan is director of the Male Clinic in Santa Monica, Calif., and a clinical? professor of urology at the University of Southern California Medical School in Los Angeles.
Dr. Steers is Chairman of the department of urology and a professor of urology at the University of Virginia Medical School in Charlottesville.
Source: Presentations by and correspondence with Harin Padma-Nathan, MD, and William Steers, MD.
Copyright of Modern Medicine is the property of Advanstar Communications Inc. and its content may not be copied or e-mailed to multiple sites or posted to a listserv without the copyright holder`s express written permission. However, users may print, download, or e-mail articles for individual use.
Source: Modern Medicine, Jul98, Vol. 66 Issue 7, p56, 2p
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