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13. Psychosocial outcomes and drug attributes affecting treatment choice in men receiving sildenafil citrate and tadalafil for the treatment of erectile dysfunction: results of a multicenter, randomized, open-label, crossover study

Author

John, Dean, Hackett, Geoffrey I., Gentile, Vincenzo, Furio Pirozzi Farina, Rosen, Raymond C., Yanli, Zhao, Warner, Margaret R., and Anthony, Beardsworth

Subjects
Adult, Male, Phosphodiesterase Inhibitors, Vasodilator Agents, design, Drug Administration Schedule, Piperazines, Sildenafil Citrate, Tadalafil, Erectile Dysfunction, Humans, Sulfones, Aged, Analysis of Variance, Cross-Over Studies, psychological assessment of sexual dysfunction, Penile Erection, Middle Aged, Self Concept, Treatment Outcome, Patient Satisfaction, Purines, methodology of clinical trials, oral vasoactive agents, erectile dysfunction, Carbolines
Abstract

Although sildenafil citrate (sildenafil) and tadalafil are efficacious and well-tolerated treatments for erectile dysfunction (ED), preference studies have shown that patients may favor one medication over the other.To determine whether psychosocial outcomes differed when men with ED received tadalafil compared with sildenafil.Measures included a treatment preference question, Psychological and Interpersonal Relationship Scales (PAIRS), and Drug Attribute Questionnaire.Randomized, open-label, crossover study. After a 4-week baseline, men with ED (N = 367; mean age = 54 years; naïve to type 5 phosphodiesterase inhibitor therapy) were randomized: tadalafil for 12 weeks then sildenafil for 12 weeks or vice versa (8-week dose optimization/4-week assessment phases). During dose optimization, patients started with 10 mg tadalafil, or 25 or 50 mg sildenafil and could titrate to their optimal dose (10 or 20 mg tadalafil; 25, 50, or 100 mg sildenafil). Medications were taken as needed. Patients completing both 12-week periods chose which medication to continue during an 8-week extension.Of 291 men completing both treatment periods, 71% (N = 206) chose tadalafil and 29% (N = 85) chose sildenafil (P0.001) for the 8-week extension. When taking tadalafil compared with sildenafil men had higher mean endpoint scores on PAIRS Sexual Self-Confidence (tadalafil = 2.91 vs. sildenafil = 2.75; P0.001) and Spontaneity (tadalafil = 3.32 vs. sildenafil = 3.17; P0.001) Domains and a lower mean endpoint score on Time Concerns Domain (tadalafil = 2.2 vs. sildenafil = 2.59; P0.001). The two most frequently chosen drug attributes to explain treatment preference were ability to get an erection long after taking the medication and firmness of erections. Tadalafil and sildenafil were well tolerated with 12 (3.3%) patients discontinuing for an adverse event.As measured with PAIRS, men with ED had higher sexual self-confidence and spontaneity and less time concerns related to sexual encounters when treated with tadalafil compared with sildenafil. These psychosocial outcomes may help explain why more men (71%) preferred tadalafil for the treatment of ED in this clinical trial.

Published
2006

17. Satisfaction in the Sex Life of a General Population Sample.

Author

Dunn, Kate M., Croft, Peter R., and Hackett, Geoffrey I.

Subjects
SATISFACTION, SEXUAL intercourse, HUMAN sexuality, MAN-woman relationships, INTERPERSONAL relations
Abstract

A questionnaire asking about satisfaction and problems in the sex lives of respondents and their partners was sent to 4,000 adults registered with general practices in England. A quarter of respondents said that they were dissatisfied with their sex lives, men more so than women, particularly with the frequency of intercourse. Respondents were more likely to be dissatisfied with their sex life if they perceived their partner to have a sexual problem. Respondents who were dissatisfied were more likely to report that their partner was dissatisfied with their sex life. The benefits of treating sexual problems have wide implications for both partners in a relationship. [ABSTRACT FROM AUTHOR]

Published
2000
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18. Is late-onset hypogonadotropic hypogonadism a specific age-dependent disease, or merely an epiphenomenon caused by accumulating disease-burden?

Author

Corona G, Maseroli E, Rastrelli G, Francomano D, Aversa A, Hackett GI, Ferri S, Sforza A, and Maggi M

Subjects
Age of Onset, Aged, Aged, 80 and over, Aging, Cost of Illness, Humans, Hypogonadism complications, Hypogonadism epidemiology, Male, Hypogonadism physiopathology
Abstract

Background: The aim of this paper is to summarize the available evidence supporting the link between late onset hypogonadism (LOH) and associated common clinical illnesses, focusing on metabolic diseases. The possible benefits or risks related to testosterone replacement therapy (TRT) in these conditions will also be analyzed., Methods: An extensive Medline search was performed., Results: LOH is closely associated with a worse metabolic profile and a higher cardiovascular risk. The relationship between hypogonadism obesity and insulin resistance is complex and bidirectional. Emerging evidence suggests a positive role of TRT in improving body composition and metabolic outcomes in subjects with LOH., Conclusions: Despite the aforementioned data, it is not completely known whether reduced testosterone levels in elderly males might play a direct pathogenetic role in these conditions or whether low T and associated morbidities are concomitant conditions, both associated with the aging process. Further and longer studies are advisable to confirm the preliminary results.

Published
2016

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