Indirect comparison of interventions using published randomised trials: systematic review of PDE-5 inhibitors for erectile dysfunction

Background: There are no randomised and properly blinded trials directly comparing one PDE-5 inhibitor with another in a normal home setting. Valid indirect comparisons with a common comparator must examine equivalent doses, similar duration, similar populations, with the same outcomes reported in t...

Full description

Bibliographic Details
Main Authors: Moore, R, Derry, S, McQuay, H
Format: Journal article
Language:English
Published: BioMed Central 2005
Subjects:
_version_ 1797078597830180864
author Moore, R
Derry, S
McQuay, H
author_facet Moore, R
Derry, S
McQuay, H
author_sort Moore, R
collection OXFORD
description Background: There are no randomised and properly blinded trials directly comparing one PDE-5 inhibitor with another in a normal home setting. Valid indirect comparisons with a common comparator must examine equivalent doses, similar duration, similar populations, with the same outcomes reported in the same way. Methods: Published randomised, double-blind trials of oral PDE-5 inhibitors for erectile dysfunction were sought from reference lists in previous reviews and electronic searching. Analyses of efficacy and harm were carried out for each treatment, and results compared where there was a common comparator and consistency of outcome reporting, using equivalent doses. Results: Analysis was limited by differential reporting of outcomes. Sildenafil trials were clinically and geographically more diverse. Tadalafil and vardenafil trials tended to use enriched enrolment. Using all trials, the three interventions were similar for consistently reported efficacy outcomes. Rates of successful intercourse for sildenafil, tadalafil and vardenafil were 65%, 62%, and 59%, with placebo rates of 23–28%. The rates of improved erections were 76%, 75% and 71%, respectively, with placebo rates of 22–24%, and NNTs of 1.9 or 2.0. Reporting of withdrawals was less consistent, but all-cause withdrawals for sildenafil, tadalafil and vardenafil were 8% 13% and 20%. All three drugs were well tolerated, with headache being the most commonly reported event at 13–17%. There were few serious adverse events. Conclusion: There were differences between trials in outcomes reported, limiting comparisons, and the most useful outcomes were not reported. For common outcomes there was similar efficacy between PDE-5 inhibitors.
first_indexed 2024-03-07T00:34:07Z
format Journal article
id oxford-uuid:80ce6586-b929-4990-835d-295ced4febe2
institution University of Oxford
language English
last_indexed 2024-03-07T00:34:07Z
publishDate 2005
publisher BioMed Central
record_format dspace
spelling oxford-uuid:80ce6586-b929-4990-835d-295ced4febe22022-03-26T21:25:59ZIndirect comparison of interventions using published randomised trials: systematic review of PDE-5 inhibitors for erectile dysfunctionJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:80ce6586-b929-4990-835d-295ced4febe2AnaestheticsEnglishOxford University Research Archive - ValetBioMed Central2005Moore, RDerry, SMcQuay, HBackground: There are no randomised and properly blinded trials directly comparing one PDE-5 inhibitor with another in a normal home setting. Valid indirect comparisons with a common comparator must examine equivalent doses, similar duration, similar populations, with the same outcomes reported in the same way. Methods: Published randomised, double-blind trials of oral PDE-5 inhibitors for erectile dysfunction were sought from reference lists in previous reviews and electronic searching. Analyses of efficacy and harm were carried out for each treatment, and results compared where there was a common comparator and consistency of outcome reporting, using equivalent doses. Results: Analysis was limited by differential reporting of outcomes. Sildenafil trials were clinically and geographically more diverse. Tadalafil and vardenafil trials tended to use enriched enrolment. Using all trials, the three interventions were similar for consistently reported efficacy outcomes. Rates of successful intercourse for sildenafil, tadalafil and vardenafil were 65%, 62%, and 59%, with placebo rates of 23–28%. The rates of improved erections were 76%, 75% and 71%, respectively, with placebo rates of 22–24%, and NNTs of 1.9 or 2.0. Reporting of withdrawals was less consistent, but all-cause withdrawals for sildenafil, tadalafil and vardenafil were 8% 13% and 20%. All three drugs were well tolerated, with headache being the most commonly reported event at 13–17%. There were few serious adverse events. Conclusion: There were differences between trials in outcomes reported, limiting comparisons, and the most useful outcomes were not reported. For common outcomes there was similar efficacy between PDE-5 inhibitors.
spellingShingle Anaesthetics
Moore, R
Derry, S
McQuay, H
Indirect comparison of interventions using published randomised trials: systematic review of PDE-5 inhibitors for erectile dysfunction
title Indirect comparison of interventions using published randomised trials: systematic review of PDE-5 inhibitors for erectile dysfunction
title_full Indirect comparison of interventions using published randomised trials: systematic review of PDE-5 inhibitors for erectile dysfunction
title_fullStr Indirect comparison of interventions using published randomised trials: systematic review of PDE-5 inhibitors for erectile dysfunction
title_full_unstemmed Indirect comparison of interventions using published randomised trials: systematic review of PDE-5 inhibitors for erectile dysfunction
title_short Indirect comparison of interventions using published randomised trials: systematic review of PDE-5 inhibitors for erectile dysfunction
title_sort indirect comparison of interventions using published randomised trials systematic review of pde 5 inhibitors for erectile dysfunction
topic Anaesthetics
work_keys_str_mv AT moorer indirectcomparisonofinterventionsusingpublishedrandomisedtrialssystematicreviewofpde5inhibitorsforerectiledysfunction
AT derrys indirectcomparisonofinterventionsusingpublishedrandomisedtrialssystematicreviewofpde5inhibitorsforerectiledysfunction
AT mcquayh indirectcomparisonofinterventionsusingpublishedrandomisedtrialssystematicreviewofpde5inhibitorsforerectiledysfunction