Document Detail


Effect of nightly versus on-demand vardenafil on recovery of erectile function in men following bilateral nerve-sparing radical prostatectomy.
MedLine Citation:
PMID:  18640769     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To date, no data have been available from large, well-designed trials comparing on demand and nightly dosing of phosphodiesterase type 5 (PDE5) inhibitors on recovery of erectile function in postprostatectomy patients with erectile dysfunction (ED). OBJECTIVE: To investigate the effect of early postoperative dosing with vardenafil, administered either nightly or on demand, compared with placebo on recovery of erectile function in men with ED following bilateral nerve-sparing radical prostatectomy (NSRP) surgery. DESIGN, SETTING, AND PARTICIPANTS: A randomised, double-blind, double-dummy, multicentre, parallel group study conducted at 87 centres across Europe, Canada, South Africa, and the United States. For inclusion, patients had to be scheduled to undergo bilateral NSRP within 1 mo of screening and have a normal International Index of Erectile Function erectile function domain (IIEF-EF) score of > or =26 at screening. A total of 628 men, aged 18-64 yr, were randomised to treatment. Study design consisted of a 9-mo double-blind treatment period, a 2-mo single-blind washout period, and an optional 2-mo open-label period. INTERVENTION: Patients received placebo, nightly vardenafil, or on demand vardenafil. MEASUREMENTS: Primary outcome measure was the percentage of subjects with an IIEF-EF score of > or =22 after the 2-mo washout period. Secondary variables included mean per-patient success rates for Sexual Encounter Profile (SEP) questions 2 and 3. RESULTS AND LIMITATIONS: No statistically significant differences were observed among treatment groups in the proportion of patients with an IIEF-EF score of > or =22 or in SEP3 success rates after the washout period. On-demand vardenafil treatment resulted in significantly greater IIEF-EF scores and better SEP3 response rates than placebo over the entire treatment period. CONCLUSIONS: In this study of men with ED following bilateral NSRP, vardenafil was efficacious when used on demand, supporting a paradigm shift towards on demand dosing with PDE5 inhibitors in this patient group. TRIAL REGISTRATION: European clinical trials database (EudraCT; available at http://eudract.emea.europa.eu/). Trial registration number: 11336.
Authors:
Francesco Montorsi; Gerald Brock; Jay Lee; JoAnn Shapiro; Hendrik Van Poppel; Markus Graefen; Christian Stief
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-07-09
Journal Detail:
Title:  European urology     Volume:  54     ISSN:  0302-2838     ISO Abbreviation:  Eur. Urol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-08     Completed Date:  2009-01-15     Revised Date:  2009-07-30    
Medline Journal Info:
Nlm Unique ID:  7512719     Medline TA:  Eur Urol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  924-31     Citation Subset:  IM    
Affiliation:
Division of Urology, Universita Vita Salute San Raffaele, Via Olgettina 60, Milan, Italy. montorsi.francesco@hsr.it
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MeSH Terms
Descriptor/Qualifier:
Double-Blind Method
Erectile Dysfunction / drug therapy*,  etiology*
Humans
Imidazoles / administration & dosage*
Male
Middle Aged
Phosphodiesterase Inhibitors / administration & dosage*
Piperazines / administration & dosage*
Prostate / innervation
Prostatectomy / adverse effects*,  methods*
Recovery of Function
Sulfones / administration & dosage
Triazines / administration & dosage
Chemical
Reg. No./Substance:
0/Imidazoles; 0/Phosphodiesterase Inhibitors; 0/Piperazines; 0/Sulfones; 0/Triazines; 224785-90-4/vardenafil
Comments/Corrections
Comment In:
Nat Clin Pract Urol. 2009 Jan;6(1):14-5   [PMID:  19065139 ]
Eur Urol. 2009 May;55(5):e95-6; author reply e97-8   [PMID:  19081174 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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