Tadalafil versussildenafil citrato nel trattamento della disfunzione erettile (DE): la preferenza dei pazienti italiani e le motivazioni della loro scelta

This is an open, multicentre, randomized, crossover study having the aim to eval- uate the preference for sildenafil citrate or tadalafil in a population of Italian patients af- fected by ED, and to compare the efficacy and safety of these two drugs. MATERIALANDMETHODS.From October 2003 to November 2004, thirteen Italian centers en- rolled ED patients (age >18) being in steady and naïve relation to ED treatment, both through PDE5 inhibitors and any other treatment option. These patients were randomized to silde- nafil or tadalafil for 12 weeks, after which they were switched to the alternative treatment for a further 12 weeks. The preference was evaluated through the Treatment Preference Question (TPQ): "During this clinical trial you have taken tadalafil and sildenafil for the treat- ment of erectile dysfunction. Which medication do you prefer to take for the next 8 weeks of treatment?". Moreover, patients were asked to express their preference as "strong" or "moderate" and to answer some questions to clarify the reasons behind their preference. SEP and IIEF-EF questionnaires were used for a comparison of efficacy. RESULTS.167 patients were enrolled, 144 of whom completed both treatment periods. On being asked the TPQ, 75% of patients (n=108) decided to continue treatment with tadalafil, in particular because it made it possible to have an erection many hours after taking the med- ication (first or second preference reason for 64.8% of patients), while 25% (n=36) preferred sildenafil (p=0.001). Both drugs improved the IIEF-EF and SEP scores compared to baseline, with a slightly but significantly greater improvement with tadalafil for both parameters. CONCLUSIONS.Tadalafil and sildenafil are both effective and well tolerated. Most of the pa- tients prefer tadalafil thanks to the possibility of having sexual intercourse many hours af- ter taking the medication.(Urologia 2008; 75: 24-31)