Abstract
AimsErectile dysfunction (ED) is a major care problem worldwide. Tadalafil and sildenafil are the two most common phosphodiesterase 5 inhibitors used to treat ED. This systematic review and meta-analysis were conducted to directly compare tadalafil with sildenafil for the treatment of ED.MethodsWe designed a strategy for searching the PubMed, Embase, EBSCO, Web of Science and Cochrane library databases; the reference lists of the retrieved studies were also investigated. A literature review was performed to identify all published randomized or non-randomized controlled trials that compared tadalafil with sildenafil for the treatment of ED and to assess the quality of the studies. Two investigators independently and blindly screened the studies for inclusion. The meta-analysis was performed using RevMan 5.0.ResultsA total of 16 trials that compared tadalafil with sildenafil for the treatment of ED were included in the meta-analysis. In the meta-analysis, tadalafil and sildenafil appeared to have similar efficacies and overall adverse event rates. However, compared with sildenafil, tadalafil significantly improved psychological outcomes. Furthermore, the patients and their partners preferred tadalafil over sildenafil, and no significant difference was found in the adherence and persistence rates between tadalafil and sildenafil. Additionally, the myalgia and back pain rates were higher and the flushing rate was lower with tadalafil than with sildenafil.ConclusionTadalafil shares a similar efficacy and safety with sildenafil and significantly improves patients’ sexual confidence. Furthermore, patients and their partners prefer tadalafil to sildenafil. Hence, tadalafil may be a better choice for ED treatment.
Highlights
Erectile dysfunction (ED) is defined as the inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse
Tadalafil may be a better choice for ED treatment
PDE5-Is are similar to cyclic guanosine monophosphate in structure; PED5-Is can bind to PDE5 competitively and inhibit
Summary
Erectile dysfunction (ED) is defined as the inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse. ED is one of the most common sexual dysfunctions, and an estimated 5–20% of men are affected by moderate to severe ED around the world [1]. The prevalence of ED is approximately 15.77% in southern India, 15.0–49.5% in China, 56.1% in Iran and 58.9% in south-western Nigeria [2,3,4,5]. The estimated global prevalence has been increasing, and approximately 322 million men worldwide could be affected by ED by the year 2025 [6]. ED is a benign disorder, it can affect physical and psychosocial health and may have a significant impact on the quality of life of patients and their partners. PDE5-Is are similar to cyclic guanosine monophosphate (cGMP) in structure; PED5-Is can bind to PDE5 competitively and inhibit
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