Study of the efficacy and preferences among severe erectile dysfunction patients after taking 3 phosphodiesterase 5 inhibitors

Objective: To evaluate the efficacy of sildenafil (100 mg), vardenafil (20 mg) and tadalafil (20mg) in the treatment of severe erectile dysfunction and to evaluate their preferences after having taken all three drugs. Material and methods: The patients took sildenafil (100 mg), vardenafil (20 mg) and tadalafil (20 mg) sequentially at least four times each over 30-45 days with a wash-out period of 7 days between one drug and the next. In total, 151 patients were included to obtain a valid sample of 108 cases (18 for each randomization group, six groups in total). The included patients had severe erectile dysfunction. Results: The IIEF scores improved compared to baseline values, these improvements being statistically significant in all cases (P < 0.0001). When the scores on the IIEF, EDITS patient version, EDITS partner version and SEP using Friedman's non-parametric test for related measures were compared, statistically significant differences were observed in all of them except SEP-2 and SEP-3. When compared with each other using Wilcoxon's test, we found statistically significant differences in the IIEF between tadalafil and sildenafil (P < 0.003) and between tadalafil and vardenafil (P < 0.001). We also found these in the EDITS partner version between sildenafil and vardenafil (P < 0.013). In the other cases except SEP-2 and SEP-3, the differences between tadalafil and the other two drugs were very close to significance. There was no difference between sildenafil and vardenafil. As for their preference for one drug over the others, 20 chose sildenafil (18.5%), 19 vardenafil (17.8%), 43 tadalafil (39.8%) and 22 did not choose any due to lack of efficacy (24.05%). Conclusions: The statistically significant differences observed when comparing the different questionnaires used lead to the belief that, apart from the subjective preference of patients per se, their preference is also based on a greater response to one drug in comparison with the others. (C) 2012 Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva. Published by Elsevier Espana, S.L. All rights reserved.