Comparative efficacy and safety of phosphodiesterase-5 inhibitors with selective serotonin reuptake inhibitors in men with premature ejaculation: A systematic review and Bayesian network meta-analysis

Jin, K.; Wei, Qingqing; Li, Yang; Qiu, Sun; Tu, Xiaoting

doi:10.1016/s1569-9056(17)32170-x

Cited by 3 publications

(3 citation statements)

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“…Test of heterogeneity were conducted with the Cochran's Q statistic and using I 2 tests. [24,25] A value of I 2 greater than 50% to indicate substantial heterogeneity and sought the potential sources of heterogeneity, such as clinical heterogeneity and methodological heterogeneity. [21] Traditional pairwise meta-analysis were also used for exploratory estimates of drug efficacy, using the R package ‘meta’ (version 4.9-4) and random-effects model was used.…”

Section: Methodsmentioning

confidence: 99%

Carbapenems vs tigecycline for the treatment of complicated intra-abdominal infections

Chen¹,

Liang²,

Jiang

et al. 2019

Medicine

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Section: Methodsmentioning

confidence: 99%

Carbapenems vs tigecycline for the treatment of complicated intra-abdominal infections

Chen¹,

Liang²,

Jiang

et al. 2019

Medicine

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“…This might be due to the fact that both drugs work in different mechanisms and different drug targets. 37 This study had some limitations. First, in terms of transitivity, the duration of treatment protocol among trials was varied, this difference might provide variety on the treatment efficacy and side effects that lead to reduced network connectivity in NMA and therefore lower the statistical power.…”

Section: Discussionmentioning

confidence: 92%

A network meta-analysis on comparative efficacy and tolerability of on-demand therapy for premature ejaculation

Yogiswara

Azmi

2020

Bali Med J.

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Introduction:The use of pharmacotherapy as a first-line treatment for premature ejaculation (PE) is recommended by EAU guidelines. However, no study had analyzed multiple treatment comparisons among available on-demand therapy. Therefore, we aimed to perform a network meta-analysis (NMA) to characterize the comparative efficacy and tolerability of on-demand therapy for PE. Methods: We systematically searched randomized controlled trials (RCTs) in several databases at any period up to November 2019. NMA was performed to estimate efficacy and tolerability outcomes using intravaginal ejaculation latency time (IELT) and overall adverse effects (AEs), respectively. We ranked each outcome using the surface under the cumulative ranking curve (SUCRA) and presented the two outcomes as a clustered ranking plot.Results: A total of 19 RCTs comprising 5950 patients were included in this NMA. All active treatments showed significant improvement compared to placebo. Among the available on-demand treatment, the combination of SSRI plus PDE5i showed the highest efficacy (MD: 3.06; 95%CI 1.84-4.29) followed by tramadol 100 mg and vardenafil 10 mg (MD 2.9, 95%CI 1.63-4.16; MD 2.36, 95%CI 1.2-3.52; respectively). Based on the SUCRA, the combination of SSRI plus PDE5i had the highest score (91.7%) in efficacy, while dapoxetine 30 mg had the highest score (73.3%) in terms of tolerability. Conclusion:The combination of SSRI plus PDE5i was the treatment of choice for individuals who prioritize efficacy. For those who prioritize tolerability, dapoxetine 30 mg and vardenafil 10 mg became alternative treatments. Various on-demand therapy options require careful discussion with patient expectations of treatment effects.

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“…10 A more recent SSRI, dapoxetine, is effective when used on demand, and it was the first drug registered as a treatment for premature ejaculation in the European Union. 11 Among other putatively efficient drugs are the opioid agonist tramadol 12 , phosphodiesterase-5 inhibitors 13 , and others with less established efficacy. 14,15 Ejaculation is not entirely a central nervous process but rather a series of events in the reproductive organs.…”

Section: Introductionmentioning

confidence: 99%

Sexual Incentive Motivation and Copulatory Behavior in Male Rats Treated with the Adrenergic α2-Adrenoceptor Agonists Tasipimidine and Fadolmidine: Implications for Treatment of Premature Ejaculation

Lehtimäki

Ventura-Aquino²,

Chu

et al. 2021

The Journal of Sexual Medicine

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Background: Premature ejaculation is the most common sexual dysfunction in young men, and it often leads to reduced relationship satisfaction and quality of life.Aim: To determine the role of central and peripheral α2-adrenoceptors in the control of ejaculation and sexual incentive motivation in rats.Methods: Sexual incentive motivation was studied in a large arena in which a male subject could choose between approaching and remaining close to a sexually receptive female or another male.Sexual behavior was studied in standard observation cages in which a male was allowed to freely interact with a receptive female for 30 min. Two highly selective agonists at the α2-adrenoceptors, tasipimidine and fadolmidine, were administered before the tests. Low peripheral doses of fadolmidine has been reported to have effects mainly outside of the central nervous system, whereas at large doses also the central effects are evident. Outcomes:The time spent close to the receptive female in relation to the time spent with the male and measures of ambulatory activity were obtained from the test for sexual incentive motivation, while the habitual parameters of sexual behavior were recorded with the copulation test.Results: Tasipimidine prolonged ejaculation latency and the interintromission interval at the dose of 200 µg/kg when data from fast-ejaculating rats were used. No other sexual parameter was modified. A dose of 100 µg/kg was ineffective. There was no consistent effect on sexual incentive motivation, although modest sedation was observed. Fadolmidine, a drug that does not easily penetrate the blood-brain barrier, had no effect on sexual incentive motivation at any of the doses used (3, 30, and 100 µg/kg). The largest dose had clear sedative effects. The lower doses had no systematic effect on sexual behavior, not even when only fast or very fast ejaculating males were analyzed. Clinical Translation:The findings are relevant to the search for treatments for premature ejaculation that are specific enough to selectively delay ejaculation. Strengths & Limitations:The procedures used here are standard in the field and yield the most reliable data. Whether the effects observed in male rats are directly transferrable to men can only be determined through clinical studies. Conclusion:The observation that drugs acting at central but not peripheral α2-adrenoceptors prolong ejaculation latency without affecting any other parameter of sexual behavior or sexual incentive motivation suggests that this kind of drug may be suitable for treating premature ejaculation.

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Comparative efficacy and safety of phosphodiesterase-5 inhibitors with selective serotonin reuptake inhibitors in men with premature ejaculation: A systematic review and Bayesian network meta-analysis

Cited by 3 publications

References 36 publications

Carbapenems vs tigecycline for the treatment of complicated intra-abdominal infections

Carbapenems vs tigecycline for the treatment of complicated intra-abdominal infections

A network meta-analysis on comparative efficacy and tolerability of on-demand therapy for premature ejaculation

Sexual Incentive Motivation and Copulatory Behavior in Male Rats Treated with the Adrenergic α2-Adrenoceptor Agonists Tasipimidine and Fadolmidine: Implications for Treatment of Premature Ejaculation

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