Digital Real-world Data Suggest Patient Preference for Tadalafil over Sildenafil in Patients with Erectile Dysfunction

Abstract

Background: Erectile dysfunction (ED) is a major care problem worldwide. Tadalafil and sildenafil are the two most common phosphodiesterase-5 inhibitors (PDE5is) used to treat ED. Objective: This study aimed to evaluate patient data of a large online prescription platform (OPP), specifically analyzing preference for tadalafil over sildenafil. Design, setting, and participants: Data from a prospectively collected German OPP were retrospectively analyzed. This dataset included patients with a history of taking one or both substances (n = 26 821). Outcome measurements and statistical analysis: ED patient baseline characteristics were derived from medical questionnaires for PDE5i prescriptions between May 2019 and May 2020. Order behavior was analyzed in patients who ordered both substances over time. We applied Kruskal-Wallis tests, x 2 tests, and fisher's exact tests for statistical analysis. Results and limitations: Baseline characteristics were comparable for both PDE5is in patients with a median age of 49 yr (sildenafil [interquartile range {IQR} 38-57]; tadalafil [IQR 39-56]), a median body mass index (BMI) of 26 kg/m 2 (sildenafil [IQR 24.54-29.03]; tadalafil [IQR 24.49-28.69]), ED onset time of >12 mo (sildenafil [87%]; tadalafil [88%]), and the presence of morning erections (sildenafil [62%]; tadalafil [61%]). Tadalafil prescriptions increased significantly from 30% (first order) to 80% (last order) in patients who had already tested both drugs. Patients with age 40 yr, BMI 25 kg/m 2 , and sustained morning erections preferred tadalafil to sildenafil. Conclusions: Using database information from an OPP, preference for tadalafil was shown for patients who had tested both PDE5is. This preference was particularly pronounced in patients with age 40 yr, BMI 25 kg/m 2 , and sustained morning erections. A wellmanaged OPP can be used for research on more complex health services. Patient summary: Analysis of large online prescription platforms provide the benefit of identifying young treatment-naïve patients with early-stage disease, which is highlighted by the fact that about two-thirds of our patients analyzed still maintained spontaneous morning erections. Patients who had tested tadalafil once developed preference for this drug.

Assessment of Patient Risk Profiles by a Male Sexual Health Direct-to-Consumer Prescription Platform: A Cross-Sectional Study

“…Anonymized patient data for analysis was provided by the DTC as described. 11 All requests from patients and the answers from the attending urologist were extracted from the medical data system. Requests were sent between February 2021 and May 2022.…”

Urologie 2030: Die dringende Notwendigkeit die Digitalisierung in der Urologie schon jetzt voranzutreiben um die medizinische Versorgung aufrecht erhalten zu können – ein Expertenkonsens

“…ist es in der Urologie vor allen Dingen die Behandlung der erektilen Dysfunktion (ED), in denen Direct-to-Patient (DTP)-Plattformen die Art und Weise der (Online-)Behandlung mitgeprägt und verändert haben. Wackerbarth Offline-und Online-Medizin könnte die Zahl der bislang unerkannten Risikogruppen erhöhen und in diesen Gruppen zu einer besseren medizinischen Versorgung führen, denn in jüngst publizierten Studien zeigte sich, dass 63,5% der DTP-Kunden zuvor keinerlei medizinische Betreuung erhalten hatten [26,27].…”

Tadalafil in patients on antihypertensive medications: Does safety remain an issue?

“…On the other hand, tadalafil is another first‐line, selective PDE5 inhibitor used to treat ED, BPH, and pulmonary hypertension since 2003, with a long duration of action, whose efficacy and tolerability are also well‐documented (Figure 1). 9,10 A higher patient preference for tadalafil compared to sildenafil has been noted, especially in younger individuals 11 . However, no head‐to‐head randomized trials exist and such observations should be cautiously interpreted.…”

“…9,10 A higher patient preference for tadalafil compared to sildenafil has been noted, especially in younger individuals. 11 However, no head-to-head randomized trials exist and such observations should be cautiously interpreted. Other PDE5 inhibitors (avanafil, lodenafil, mirodenafil) appear to be less effective or safe than sildenafil and Tadalafil.…”