Patients’ preference in the treatment of erectile dysfunction: a critical review of the literature

Abstract

The increase in the number of safe and effective ED treatments highlights the importance of patients' preference when choosing a therapeutic option. Several studies assessing these preferences are now available in published literature. This article aims to review and discuss the studies on patients' preference and the data concerning the reasons for preference for one PDE-5 inhibitor over another. A PubMed search was conducted for manuscripts published within the last 10 years containing the search items ED, preference, sildenafil, tadalafil or vardenafil. Selected articles were discerningly reviewed and summarized (design, limitations and relevance). The articles selected were peer reviewed publications on patients' preference and ED published in medical literature since 2000. Preference studies that include either two (tadalafil and sildenafil) or three PDE-5 inhibitors (tadalafil, sildenafil and vardenafil), showed that the majority of the patients preferred tadalafil versus either vardenafil or sildenafil. As the treatment of ED has evolved, patients' preference has become an important aspect of ED therapy, 52-65% of patients prefer tadalafil versus 12-20% vardenafil or 8-30% sildenafil. All founded studies have serious limitations, particularly in terms of dosing differences. Preference for tadalafil was mainly because of the longer duration of action that increases patients' freedom in sexual life. There is a consistency in patients' preference for tadalafil over sildenafil or vardenafil across the studies reviewed.

SOP Conservative (Medical and Mechanical) Treatment of Erectile Dysfunction

“…Several sponsored and independent nonsponsored studies have investigated whether patients/couples prefer one PDE5 inhibitor over others after patients tried sildenafil, vardenafil, and/or tadalafil over a reasonably long period of time. A recent review of the literature from 2000 to 2010 on this topic concluded that preferences of the patients/ couples were the following [71]:…”

A Systematic Review Assessing the Economic Impact of Sildenafil Citrate (Viagra®) in the Treatment of Erectile Dysfunction

“…Erectile dysfunction (ED) is the consistent inability of a man to achieve or maintain penile erection sufficient for sexual activity . Common causes of ED include aging and endothelial dysfunction associated with behaviors such as smoking or conditions including type 2 diabetes mellitus (T2DM), hypertension (HTN), and other cardiovascular diseases.…”

Treatment satisfaction among men with concurrent benign prostatic hyperplasia and erectile dysfunction treated with tadalafil or other phosphodiesterase type-5 inhibitor combinations

“… 16 Additionally, the greater ease of planning and convenience findings were consistent with prior research on patient preferences showing that a majority of patients preferred tadalafil over either sildenafil or vardenafil; patients perceived that tadalafil allowed them greater sexual spontaneity. 30 Moreover, while BPH/LUTS improved significantly with either tadalafil or tamsulosin monotherapy, relative to a placebo, only tadalafil significantly improved ED symptoms. 17 Therefore, the collective evidence suggests that men may not only be more satisfied with the efficacy of tadalafil treatment for BPH with (or without) ED but they may also perceive this treatment to be more convenient than some alternative pharmacotherapies.…”