The effectiveness of phosphodiesterase type 5 inhibitors （PDE5-1s） for erectile dysfunction （ED） varies considerably among trials, but available studies investigating the factors that affect the effectiveness are ...The effectiveness of phosphodiesterase type 5 inhibitors （PDE5-1s） for erectile dysfunction （ED） varies considerably among trials, but available studies investigating the factors that affect the effectiveness are few and findings are not consistent. A systematic search was performed in PubMed, Cochrane Library, and EMBASE to identify randomized controlled trials comparing PDE5-1s with placebo for the treatment of ED. The methodological quality of included studies was assessed by the Cochrane Collaboration＇s tool for assessing risk of bias. The associations between prespecified study-level factors and effectiveness were tested by a random effects meta-regression model. This study included 93 trials with 26 139 patients. When all PDE5-1s were grouped together, Caucasian ethnicity was associated with 15.636% （95% confidence interval [CI]： 0.858% to 32.579%） increase in risk ratio （RR） for Global Assessment Questionnaire question-1 （GAQ-1）, and 1.473 （95% CI： 0.406 to 2.338） score increase in mean difference （MD） for posttreatment International Index of Erectile Function-Erectile Function domain score （IIEF-EF）, compared to Asian ethnicity. A one-score increase in baseline IIEF-EF was associated with -5.635% （95% CI： -9.120% to -2.017%） reduction in RR for GAQ-1, and -0.229 （95% CI： -0.425 to -0.042） score decrease in MD for posttreatment IIEF-EF. In conclusion, PDE5-1s are more effective in Caucasians than Asians, and in patients with more severe ED.展开更多
文摘The effectiveness of phosphodiesterase type 5 inhibitors （PDE5-1s） for erectile dysfunction （ED） varies considerably among trials, but available studies investigating the factors that affect the effectiveness are few and findings are not consistent. A systematic search was performed in PubMed, Cochrane Library, and EMBASE to identify randomized controlled trials comparing PDE5-1s with placebo for the treatment of ED. The methodological quality of included studies was assessed by the Cochrane Collaboration＇s tool for assessing risk of bias. The associations between prespecified study-level factors and effectiveness were tested by a random effects meta-regression model. This study included 93 trials with 26 139 patients. When all PDE5-1s were grouped together, Caucasian ethnicity was associated with 15.636% （95% confidence interval [CI]： 0.858% to 32.579%） increase in risk ratio （RR） for Global Assessment Questionnaire question-1 （GAQ-1）, and 1.473 （95% CI： 0.406 to 2.338） score increase in mean difference （MD） for posttreatment International Index of Erectile Function-Erectile Function domain score （IIEF-EF）, compared to Asian ethnicity. A one-score increase in baseline IIEF-EF was associated with -5.635% （95% CI： -9.120% to -2.017%） reduction in RR for GAQ-1, and -0.229 （95% CI： -0.425 to -0.042） score decrease in MD for posttreatment IIEF-EF. In conclusion, PDE5-1s are more effective in Caucasians than Asians, and in patients with more severe ED.
