Efficacy of dapoxetine treatment in Chinese patients with premature ejaculation and possible factors affecting efficacy in the real-world practice

Abstract

Background: The treatment effect of dapoxetine in real-world practice is not well established. This study was to investigate the factors influencing efficacy of dapoxetine for the treatment of Premature ejaculation (PE) in the realworld setting. Methods: Altogether 154 patients were followed up between Jan 2015 and Dec 2015. The clinical global impression of change (CGIC), premature ejaculation profile (PEP), the estimated intravaginal ejaculation latency time (eIELT) and estimated number of intravaginal thrusts before ejaculation (NITBE) were collected. The clinical characteristics of patients with CGIC = 0 and CGIC≥1 were compared. Results: After 4 weeks treatment, an obvious improvement compared with the baseline was found regarding mean eIELT (2.4 ± 1.6 min vs 1.0 ± 0.7 min, P < 0.001) and mean NITBE (85.9 ± 61.9 times vs 37.4 ± 28.6 times, P < 0.001). The proportion of patients with a self-evaluation of at least "slightly better" and were categorized into "CGIC≥1" group was 70.1%. There were significant differences between patients in the "CGIC = 0" and "CGIC≥1" groups regarding mean NITBE (P = 0.010) and PEDT (P = 0.009) score at baseline. The adverse effects were acceptable. Conclusion: Dapoxetine was well-tolerated and improved the sexual satisfaction of patients with PE. The severity of PE based on PEDT and NITBE suggest that there could be an effectiveness change with dapoxetine use in realworld practice.

An Internally Validated Nomogram for Predicting the Likelihood of Improvement of Clinical Global Impression in Patients with Lifelong Premature Ejaculation Treated with Dapoxetine

“…2) had a nearly 0.36-fold chance of achieving iCGI compared with those who reported slight or no difficulties in delayed ejaculation (Q1 score of PEDT 1). This finding was in agreement with that in a study by Peng et al, 8 in which patients with PE with milder symptoms before treatment were more likely to demonstrate improvement with dapoxetine. In addition, pretreatment IELT, as the variable with the highest predictive accuracy, had a significantly lower accuracy than our nomogram (0.639 vs 0.710, P < .001), and using pretreatment IELT alone, an individual's iCGI likelihood of less than 30% can persist even if his IELT is up to 2 minutes according to our nomogram.…”

“…27 In the present study, more frequent satisfaction from sexual intercourse (ie, higher IIEF-5 [Q5] score) before dapoxetine treatment was associated with a higher chance of achieving iCGI, and this phenomenon may be attributed to the following reasons: (i) patients with more frequent satisfaction were more likely to have better erectile function, which represents better ejaculation function, thereby supporting the aforementioned hypothesis, 27 and (ii) patients with PE with better pretreatment ejaculatory function were more likely to benefit from dapoxetine treatment. 8 Interestingly, years of education was found to be associated with iCGI in our study. According to multivariate logistic regression results, a 2.61-fold chance of achieving iCGI was noted in patients with LPE with at least a bachelor's degree (years of education !…”

“…2 PE interferes with sexual satisfaction and can further result in mental health concerns and interpersonal difficulties. 7 Fortunately, dapoxetine, the only on-label oral treatment for PE 8 that is given on demand, has been proven to delay ejaculation by approximately threefold, improve overall sexual satisfaction, and reduce psychological and relationship issues. 9 However, in clinical practice, nearly 30% of patients with PE discontinue dapoxetine treatment within 1 month, mainly because of unmet expectations and side effects, 10 although the response rate is nearly 75% and the mean intravaginal ejaculation latency time (IELT) was prolonged.…”

An update on the treatment of premature ejaculation: A systematic review

“…According to the GIC results, 81.13% of the patients were satisfied with the treatment. Peng et al, 2020 [ 160 ] POS Dapoxetine 30 mg 4 weeks 154 An obvious improvement compared with the baseline was found regarding mean (SD) IELT [2.4 (1.6) vs1.0 (0.7) min; P < 0.001) and mean NITBE [85.9 (61.9) vs 37.4 (28.6) times; P < 0.001). The proportion of patients with a self-evaluation of at least ‘slightly better’ and were categorised into ‘CGIC ≥1ʹ group was 70.1%.…”

“…Pharmacological interventions (Table 3) [24,26,27,32,47,48,[50][51][52][55][56][57][58][59]66,67,72,73,[76][77][78][79]81,[84][85][86][87]89,90,116,[151][152][153][154][155][156][157][158][159][160][161][162][163]…”