Keywords
efficacy
erectile dysfunction
cronic disease
men
therapeutics
erectile dysfunction
cronic disease
men
therapeutics
How to Cite
Espitia, F. J., & Orozco, L. (2019). Efficacy of two phosphodiesterase 5 inhibitors combined with ginkgo biloba in erectile dysfunction in men with chronic diseases. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 6(3), 155–163. https://doi.org/10.53853/encr.6.3.529
Abstract
Objective: To compare the therapeutic efficacy of two selective inhibitors of 5-phosphodiesterase in combination with ginkgo biloba for the treatment of erectile dysfunction in men with chronic concomitant diseases.
Material and methods: Controlled, masked and randomized clinical trial; made between july 2013 and december 2016. Men older than 45 years with non-psychogenic erectile dysfunction in treatment for chronic diseases were included. The variables of primary interest were: international index of erectile function score, monthly coital frequency, time of drug response, percentage of satisfaction of the improvement of the dysfunction and adverse effects. Quantitative variables are presented as continuous variables through measures of central tendency and dispersion.
Results: 22 men were treated with tadalafil plus ginkgo biloba (group A) and 23 with vardenafil plus ginkgo biloba (group B); mean age 57.6 ± 8.4 years and 58.2 ± 7.8 for each group, respectively. The score of the initial international index of erectile function was 9.63 ± 1.26 (group A) and 10.35 ± 1.59 (group B); at the end of the study it was 21.78 ± 0.9 (group A), and 18.57 ± 0.3 (group B), p <0.015. At the end of the study, group A increased sexual activity from 2 sexual encounters per month to 9, while group B increased from 2 to 6, p <0.021.
Conclusions: The combination tadalafil plus ginkgo biloba has a satisfactory therapeutic efficacy on the improvement in the international index of erectile function score, favoring the monthly coital frequency, with time of onset of action and less adverse effects.
References
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17. Kang BJ, Lee SJ, Kim MD, Cho MJ. A placebo-controlled, double-blind trial of Ginkgo biloba for antidepressant-induced sexual dysfunction. Hum Psychopharmacol. 2002;17(6):279-84.
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24. Davis-Joseph B, Tiefer L, Melman A. Accuracy of the initial history and physical examination to establish the etiology of erectile dysfunction. Urology. 1995;45(3):498-502.
25. Reece C, Kumar R, Nienow D, Nehra A. Extending the rationale of combination therapy to unresponsive erectile dysfunction. Rev Urol. 2007;9(4):197-206.
26. Goldstein I, Young JM, Fischer J, Bangerter K, Segerson T, Taylor T, et al. Vardenafil, a new phosphodiesterase type 5 inhibitor, in the treatment of erectile dysfunction in men with diabetes: a multicenter double-blind placebo-controlled fixed-dose study. Diabetes Care. 2003;26(3):777-83.
27. Segraves RT, Lee J, Stevenson R, Walker DJ, Wang WC, Dickson RA. Tadala- fil for treatment of erectile dysfunction in men on antidepressants. J Clin Psychopharmacol. 2007;27(1),62-6.
28. Sáenz de Tejada I, Anglin G, Knight JR, Emmick JT. Effects of tadalafil on erectile dysfunction in men with diabetes. Diabetes Care. 2002;25(12):2159-64.
29. Giuliano F, Sánchez-Ramos A, Löchner-Ernst D, Del Popolo G, Cruz N, Leriche A, et al. Efficacy and safety of Tadalafil in men with erectile dysfunction following spinal cord injury. Arch Neurol. 2007;64(11):1584-92.
30. Martin-Morales A, Haro JM, Beardsworth A, Bertsch J, Kontodimas S, EDOS Group. Therapeutic effectiveness and patient satisfaction after 6 months of treatment with tadalafil, sildenafil, and vardenafil: results from the erectile dysfunction observational study (EDOS). Eur Urol. 2007;51(2):541-50.
31. Coward RM, Carson CC. Tadalafil in the treatment of erectile dysfunction. Ther Clin Risk Manag. 2008;4(6):1315-30.
32. Broderick GA. Oral pharmacotherapy and the contemporary evaluation and management of erectile dysfunction. Rev Urol. 2003;57:S9-S20.
33. Eardley I, Ellis P, Boolell M, Wulff M. Onset and duration of action of sildenafil for the treatment of erectile dysfunction. Br J Clin Pharmacol. 2002;531:61S-5S.
34. Sánchez-Cruz JJ, Cabrera-León A, Martín-Morales A, Fernández A, Burgos R, Rejas J. Male erectile dysfunction and health-related quality of life. Eur Urol. 2003;44(2):245-53.
35. Eardley I, Cartledge J. Tadalafil (Cialis) for men with erectile dysfunction. Int J Clin Pract. 2002;56(4):300-4.
36. Oelke M, Weiss JP, Mamoulakis C, Cox D, Ruff D, Viktrup L. Effects of tadalafil on nighttime voiding (nocturia) in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a post hoc analysis of pooled data from four randomized, placebo-controlled clinical studies. World J Urol. 2014;32(5):1127-32.
37. Vickers MA, Wright EA. Erectile dysfunction in the patient with diabetes mellitus. Am J Manag Care. 2004;10(1):S3-11.
2. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts male aging study. J Urol. 1994;151(1):54-61.
3. Ponholzer A, Temml C, Mock K, Marszalek M, Obermayr R, Madersbacher S. Prevalence and risk factors for erectile dysfunction in 2869 men using a validated questionnaire. Eur Urol. 2005;47(1):80-5.
4. Yavuzgil O, Altay B, Zoghi M, Gürgün C, Kay?kç?o?lu M¸ Kültürsay H. Endothelial function in patients with vasculogenic erectile dysfunction. Inter J Cardiol. 2005;103(1):19-26.
5. Derby CA, Mohr BA, Goldstein I, Feldman HA, Johannes CB, McKinlay JB. Modifiable risk factors and erectile dysfunction: can lifestyle changes modify risk? Urology. 2000;1;56(2):302-6.
6. Villamil I, Díaz JA, Sánchez J, García F, Saborido J, Iglesias M. Disfunción eréctil: un problema poco valorado en Medicina Interna. Estudio de pacientes y medicación relacionada. An Med Inter (Madrid). 2006;23:115-8.
7. Esposito K, Giugliano F, Di Palo C, Giugliano G, Marfella R, D’Andrea F, et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA. 2004;291(24):2978-84.
8. Corona G, Mannucci E, Mansani R, Petrone L, Bartolini M, Giommi R, et al. Organic, relational and psychological factors in erectile dysfunction in men with diabetes mellitus. Eur Urol. 2004;46(2):222-8.
9. Manrique H, Cornejo P, Arismendiz L, Pamo A. Características clínicas y prevalencia de disfunción eréctil en pacientes con diabetes mellitus 2. Rev Soc Perú Med Interna. 2002;15(2).
10. Seftel AD, Sun P, Swindle R. The prevalence of hypertension, hyperlipidemia, diabetes mellitus and depression in men with erectile dysfunction. J Urol. 2004;171(6):2341-5.
11. Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999;11(6):319-26.
12. Hatzichristou D, Rosen RC, Broderick G, Clayton A, Cuzin B, Derogatis L, et al. Clinical evaluation and management strategy for sexual dysfunction in men and women. J Sex Med. 2004;1(1):49-57.
13. Gresser U, Gleiter CH. Erectile dysfunction: comparison of efficacy and side effects of the PDE-5 inhibitors sildenafil, vardenafil and tadalafil- -review of the literature. Eur J Med Res. 2002;7(10):435-46.
14. Montorsi F, Verheyden B, Meuleman E, Jünemann KP, Moncada I, Valiquette L, et al. Long-term safety and tolerability of tadalafil in the treatment of erectile dysfunction. Eur Urol. 2004;45(3):339-45.
15. Crowe SM, Streetman DS. Vardenafil treatment for erectile dysfunction. Ann Pharmacother. 2004;38(1):77-85.
16. Eardley I, Donatucci C, Corbin J, El-Meliegy A, Hatzimouratidis K, McVary K, et al. Pharmacotherapy for erectile dysfunction. J Sex Med. 2010;7(1):524-40.
17. Kang BJ, Lee SJ, Kim MD, Cho MJ. A placebo-controlled, double-blind trial of Ginkgo biloba for antidepressant-induced sexual dysfunction. Hum Psychopharmacol. 2002;17(6):279-84.
18. Klein J, Chatterjee SS, Löffelholz K. Phospholipid breakdown and choline release under hypoxic conditions: inhibition by bilobalide, a constituent of Ginkgo biloba. Brain Res. 1997;755(2):347-50.
19. Janssens D, Remacle J, Drieu K, Michiels C. Protection of mitochondrial respiration activity by bilobalide. Biochem Pharmacol. 1999;58(1):109-19.
20. Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Ther. 1998;24(2):139-43.
21. Wheatley D. Triple-blind, placebo-controlled trial of Ginkgo biloba in sexual dysfunction due to antidepressant drugs. Hum Psychopharmacol. 2004;19(8):545-8.
22. Carey RM, Whelton PK; 2017 ACC/AHA Hypertension Guideline Writing Committee. Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Synopsis of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline. Ann Intern Med. 2018;168(5):351-8. doi: 10.7326/M17-3203
23. Espitia-De La Hoz FJ. Mi primer año en La Crónica. 1a edición. Bogotá: Editorial Bolívar. 2016. p.150-1.
24. Davis-Joseph B, Tiefer L, Melman A. Accuracy of the initial history and physical examination to establish the etiology of erectile dysfunction. Urology. 1995;45(3):498-502.
25. Reece C, Kumar R, Nienow D, Nehra A. Extending the rationale of combination therapy to unresponsive erectile dysfunction. Rev Urol. 2007;9(4):197-206.
26. Goldstein I, Young JM, Fischer J, Bangerter K, Segerson T, Taylor T, et al. Vardenafil, a new phosphodiesterase type 5 inhibitor, in the treatment of erectile dysfunction in men with diabetes: a multicenter double-blind placebo-controlled fixed-dose study. Diabetes Care. 2003;26(3):777-83.
27. Segraves RT, Lee J, Stevenson R, Walker DJ, Wang WC, Dickson RA. Tadala- fil for treatment of erectile dysfunction in men on antidepressants. J Clin Psychopharmacol. 2007;27(1),62-6.
28. Sáenz de Tejada I, Anglin G, Knight JR, Emmick JT. Effects of tadalafil on erectile dysfunction in men with diabetes. Diabetes Care. 2002;25(12):2159-64.
29. Giuliano F, Sánchez-Ramos A, Löchner-Ernst D, Del Popolo G, Cruz N, Leriche A, et al. Efficacy and safety of Tadalafil in men with erectile dysfunction following spinal cord injury. Arch Neurol. 2007;64(11):1584-92.
30. Martin-Morales A, Haro JM, Beardsworth A, Bertsch J, Kontodimas S, EDOS Group. Therapeutic effectiveness and patient satisfaction after 6 months of treatment with tadalafil, sildenafil, and vardenafil: results from the erectile dysfunction observational study (EDOS). Eur Urol. 2007;51(2):541-50.
31. Coward RM, Carson CC. Tadalafil in the treatment of erectile dysfunction. Ther Clin Risk Manag. 2008;4(6):1315-30.
32. Broderick GA. Oral pharmacotherapy and the contemporary evaluation and management of erectile dysfunction. Rev Urol. 2003;57:S9-S20.
33. Eardley I, Ellis P, Boolell M, Wulff M. Onset and duration of action of sildenafil for the treatment of erectile dysfunction. Br J Clin Pharmacol. 2002;531:61S-5S.
34. Sánchez-Cruz JJ, Cabrera-León A, Martín-Morales A, Fernández A, Burgos R, Rejas J. Male erectile dysfunction and health-related quality of life. Eur Urol. 2003;44(2):245-53.
35. Eardley I, Cartledge J. Tadalafil (Cialis) for men with erectile dysfunction. Int J Clin Pract. 2002;56(4):300-4.
36. Oelke M, Weiss JP, Mamoulakis C, Cox D, Ruff D, Viktrup L. Effects of tadalafil on nighttime voiding (nocturia) in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a post hoc analysis of pooled data from four randomized, placebo-controlled clinical studies. World J Urol. 2014;32(5):1127-32.
37. Vickers MA, Wright EA. Erectile dysfunction in the patient with diabetes mellitus. Am J Manag Care. 2004;10(1):S3-11.
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