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In January 2017, the PubMed, EBSCO, Web of Science, Cochrane library and Embase databases were searched viagra tablets generic name for randomized or non-randomized controlled clinic trials of sildenafil and tadalafil. The search was performed by combining the term “erectile dysfunction or sexual dysfunction” with the following words describing the drug: tadalafil or Cialis and sildenafil or Viagra. We also searched for additional relevant studies by examining the reference lists of the selected papers and reviews.

The search process was not limited by language, country or year of publication. For the present systematic review, randomized or non-randomized controlled trials that met the following criteria were included: (a) the study included a comparison between sildenafil and tadalafil; (b) the study provided accurate data that applied to a meta-analysis, including the International Index of Erectile Function (IIEF)-EF domain, preference and treatment–emergent adverse events (TEAEs); and (c) the full text of the study could be acquired.

When the same study was published in different journals or in different years, the most recent version was used for the meta-analysis.

Abstracts, reviews and articles that did not contain accurate relevant data and a comparative analysis of sildenafil and tadalafil were excluded.

Two independent reviewers evaluated all identified publications, and any disagreement between reviewers was resolved by a third reviewer.

The methodological quality was assessed using the Jadad score, with a Jadad score ?3 indicating a high-quality article [16]. Data extractions were performed by one reviewer and checked by a second reviewer. Information was extracted from the studies that met the above-mentioned inclusion best place to buy viagra online 2015 criteria using a structured form.

The first author, publication year, sample size, therapy that the patients received and assessment indices, including the IIEF, the men’s preference, the Self-Esteem and Relationship questionnaire (SEAR), total Erectile Dysfunction Inventory of Treatment viagra gel for sale Satisfaction (EDITS) scores and TEAEs, were collected for each study. A meta-analysis of comparable data was performed using RevMan 5.0.

Statistical heterogeneity between studies was assessed using the I 2 statistic.

Pronounced heterogeneity was indicated by a P value ?0.05 and an I 2 value ?50%; in these cases, a randomized effects model

was

A P value ?0.05 and I viagra pills pharmacy viagra tablets generic name 2 ? 50 indicated viagra woman tablet price no obvious heterogeneity between the studies, and a fixed effects model was chosen for the meta-analysis.

Continuous data are presented as weighted mean differences (WMDs), and odds ratios (ORs) were calculated for dichotomy [both with 95% confidence intervals (CIs)].

Egger’s test was performed to evaluate the risk of publication bias. Additionally, a sensitivity analysis was performed to assess the stability of the outcome when low-quality and highly heterogeneous trials were included in the analysis. A total of 1657 articles were identified through the electronic databases and the manual review of the reference lists of the included studies. Based on the search strategy, a total of 16 studies were included in the review [17–31]. A total of 5189 patients were recruited in the final meta-analysis, and the mean patient age ranged from 36.9 to 56.2 years.

Seven articles were open-label, randomized, multicentre, controlled studies; nine of the studies had a crossover design; and the other studies were prospective and observational. The common instruments used to assess these two PDEIs (sildenafil and tadalafil) were the IIEF-EF, preference, TEAEs, adherence and persistence. The characteristics of the studies are listed in Table 1 .

Author Year Number Intervention Control Assessment Jadad score Bai et al. 2016 383 Tadalafil: 20 mg Sildenafil: 100 mg preference, TEAEs 2 Buvat et al. 2013 770 Tadalafil: 5 mg OaD, 10 mg PRN Sildenafil: 50 mg PRN IIEF score, TEAEs 2 Helen viagra tablets generic name et al.

2008 100 Tadalafil: 20 mg Sildenafil: 100 mg Preference, IIEF-EF, TEAEs 2 Eardley et al.

2005 291 Tadalafil: 10 mg, 20 mg Sildenafil: 25,50,100 mg Preference, IIEF, TEAEs 2 Govier et al. 2003 215 Tadalafil: 20 mg Sildenafil: 50 mg Preference, TEAEs 3 Hatzimouratids et al. 2014 770 Tadalafil: 2.5, 5 mg OaD; 10, 20 mg PRN Sildenafil: 25, 50, 100 mg PRN IIEF 3 Rubio-Aurioles et al.

2012 418 Tadalafil: 5 mg OaD, 20 mg PRN Sildenafil: 100 mg PRN IIEF, TEAEs 2 Rodriguez Tolra et al.

2006 90 Tadalafil: 20 mg Sildenafil: 50 mg, vardenafil: 20 mg IIEF, preference, TEAEs 2 Von Keitz et al.

2004 265 Tadalafil: 20 mg Sildenafil: 50 mg preference, TEAEs 3 Li et al. 2016 63 tadalafil: 20 mg sildenafil: 100 mg preference, IIEF 2 Cairol et al. 2014 104 Tadalafil Sildenafil, vardenafil, lodenafil IIEF, persistence and adherence 2 Stroberg et al.

2003 147 Tadalafil: 20 mg Sildenafil: 25, 50, 100 mg preference, TEAEs 2 Ahn et al.

2007 160 Tadalafil: 20 mg Sildenafil: 50, 100 mg preference, TEAEs 2 El-Meliegy et al.

2013 493 Tadalafil Sildenafil, vardenafil persistence, adherence, IIEF, 2 Taylor et al.

2009 409 Tadalafil Sildenafil, vardenafil TEAEs 2 Rubio-Aurioles et al. 2013 511 Tadalafil Sildenafil, vardenafil persistence, adherence IIEF 2. TEAE treatment–emergent adverse events, IIEF International Index of Erectile Function, OaD once a day, PRN on demand. Egger’s test was conducted to assess the presence of possible publication bias.

No evidence of publication bias was found for the IIEF-EF, preference, overall adverse events, back pain, dyspepsia, nasopharyngitis, adherence and persistence (Egger’s test P ? 0.05).

The Egger’s test results found publication bias for headache, flushing and nasal congestion ( P ? 0.05).

The other parameters were not evaluated using Egger’s test because only two studies included relevant data (Tables 2 , ? ,3; 3 ; Figs. Study quality was evaluated with the Jadad scoring system, and the results are shown in Table 1 . According to a recent network meta-analysis published in 2015 that indirectly compared the efficacy and safety of PDEIs, sildenafil had the greatest efficacy but the highest rate of overall adverse events, whereas tadalafil had intermediate efficacy and the lowest overall rate of all adverse events [15]. However, our study, which differs from previous systematic reviews, is the first meta-analysis to directly compare the efficacy and safety of sildenafil and tadalafil. PDE5-Is selectively block the PDE5 enzyme, which catalyses the hydrolysis of cGMP to GMP and thus prolongs erectile function [32]. PDEIs are the most commonly used drugs to treat ED, and the effects of the PDEIs used to treat ED have been investigated.

The IIEF viagra tablets generic name is a widely used, validated and self-administered questionnaire that has demonstrated a high degree of sensitivity and specificity for the assessment of ED [33]. First, we used the IIEF to evaluate the overall efficacy of sildenafil and tadalafil.

Previous studies reported that PDEIs were more effective than placebos for treating ED and were generally safe and well tolerated [13]. Interestingly, our efficacy analysis revealed that sildenafil and tadalafil had equivalent abilities to improve IIEF-EF scores. No significant between-group differences for tadalafil and sildenafil were evident for the IIEF sexual desire, IIEF intercourse satisfaction and IIEF overall satisfaction domains. This finding is somewhat unexpected and may result from differences in the distribution of efficacy profiles within the different treatment strata assessed.

However, a high level of significant between-trial heterogeneity was evident across the articles included in this meta-analysis, and the time or dose of administration of the PDEIs was diverse.

The sensitivity analysis based on various exclusion criteria did not alter the forest plot and pooled effect, which strengthened our result. Visit Back2BU for the latest updates and information on BU's response to COVID-19.

Students can find additional information in the Undergraduate Student Guide and Graduate & Professional Student Guide. Goals Center for Sexual Medicine Faculty and Staff Make an Appointment For Health Care Professionals Training Opportunities. The most common sexual dysfunctions in men include lack of interest, premature ejaculation and erectile dysfunction.

The latter affects 52% of men between the ages of 40 and 70, including mild, moderate and complete forms of ED. Organic or physical causes for sexual dysfunction in men include vascular, hormonal and neurologic factors.

Concerning vascular causes, the risk factors for atherosclerosis (including smoking, high blood pressure, diabetes (diabetics do not respond well to pills like sildenafil (Viagra)) and high cholesterol are ALSO risk factors for erectile dysfunction. Since a straddle injury or use of a narrow saddle can obstruct and impair arteries to the penis, bicycle riding is also considered a risk factor for erectile dysfunction. Little attention has been paid to endocrine factors.

Testosterone modulates desire, arousal and orgasmic function. Concerning the orgasmic response, testosterone modulates the integrity of genital sensory receptors. Concerning the arousal response, decreased testosterone blood levels can influence the efficacy of sildenafil (Viagra).

If the sildenafil response is not reliably improving erection, the physician should first check if the patient is viagra tablets generic name taking the pill correctly.

The physician should also check the patient’s testosterone level.

One investigator in Italy gave testosterone to patients with low testosterone who did not respond to sildenafil (Viagra).

When daily testosterone was given, subsequent sildenafil (Viagra) use resulted in IIEF (the International Index of Erectile Function questionnaire used to determine erectile function) scores improving significantly. Other risk factors for erectile dysfunction include neurologic problems (multiple sclerosis, stroke), depression and medications for treating diabetes, hypertension, heart disease and depression.

There are many oral therapies for erectile dysfunction, but the only approved medication in the US is the PDE 5 enzyme inhibitor sildenafil (Viagra).

Unapproved therapies, some of which are available in the US and some elsewhere, some of which have data to prove efficacy and some not, include tadalafil (Cialis), vardenafil (Levitra), yohimbine, phentolamine, trazodone, apomorphine and neutraceuticals. PDE5 inhibitors act to relax penile erectile tissues with sexual stimulation thus enhancing your ability to get an erection. Sildenafil (Viagra) is effective for all sorts of erectile dysfunction in 69% of people. In some cases the erection is not hard enough, sometimes sildenafil (Viagra) just doesn’t work.

Structurally vardenafil (Levitra) is similar to sildenafil, while tadalafil (Cialis) is very different. Vardenafil (Levitra) is almost 10 times more biochemically potent than sildenafil, therefore a lower dose is needed to facilitate the penile erection, potentially resulting in less side effects.

Selectivity is the ability of the drug to attach to the specific enzyme PDE 5 found in penile tissues.

Vardenafil (Levitra) is more selective than sildenafil and tadalafil (Cialis) to PDE5, which again means a lower dose is needed with potentially less side effects.