Cialis Is Effective In The Treatment Of Men With Erectile Dysfunction Regardless Of Previous Effective Viagra Use

Main Category: Erectile Dysfunction / Premature Ejaculation
Also Included In: Urology / Nephrology
Article Date: 25 Apr 2006 - 0:00 PST

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UroToday.com - The phosphodiesterase type 5 (PDE-5) inhibitors have revolutionized the pharmacologic management of erectile dysfunction (ED). Viagra‚ (sildenafil citrate) was the first of the class to be introduced in 1998 and later followed by Levitra‚ (Vardenafil) and Cialis‚ (Tadalafil) in 2003. Therefore, men currently taking Cialis‚ may have had previous experience with Viagra‚. Because of the unique properties of each drug, many patients will try more than one of these agents.

Dr. Broderick of the Mayo clinic in Jacksonville, Florida and colleagues recently reviewed 14 placebo controlled, double-blinded trials of Cialis‚ use in men who were either previous Viagra‚ responders or naďve to the PDE-5 class of medications. A total of almost 2800 men were analyzed for this study. Patients who failed to have an erectile response to Viagra‚ were excluded from this analysis.

The investigators found that Cialis‚ at 10 or 20 mg improved erectile function over placebo regardless of previous Viagra use or PDE-5 inhibitor naive patients. Conclusions were based on results measured by the International Index of Erectile Function (IIEF) EF domain score, Sexual Encounter Profile (SEP) questions Q2 (successful penetration) and Q3 (successful intercourse) and a Global Assessment Question (GAQ1) about erectile improvement.

By Raymond Pak, MD

Reference:
J Sex Med 2006; 3(Suppl 1): Abstract 16.
Link Here.
Broderick GA, Donatucci CF, Hatzicristou D, Torres LO, Valiquette L, Zhao Y, and Ahuja S.

Editorial Comment: Conducting a clinical trial in the post-Viagra clinical era is difficult. Most trials exclude patients who have tried and failed to respond to Sildenafil citrate, leaving the patient population as those men who may have tried and been successful with sildenafil or those that have never tried any phophodiesterase type 5 inhibitor. An automatic criticism is that this patient population is enhanced, with potential failures screened out from the very beginning. There is no doubt that whether or not men entering clinical trials have tried Viagra or not, their expectations are different from men volunteering for clinical trials in ED prior to 1998. Expectations are an important factor even in placebo controlled trials. The above clinical trial suggests that Cialis when administered to two groups of men (prior successful Sildenafil use and Sildenafil naďve patients) is equally effective. The study was not designed to suggest or conclude that Cialis is more effective than Sildenafil.

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