title: Prospective, randomized, open-label, fixed-dose, crossover study to establish preference of patients with erectile dysfunction after taking the three PDE-5 inhibitors.
abstract: BACKGROUND
  We conducted a prospective, randomized, open-label, fixed-dose preference study, with a crossover design, using sildenafil, vardenafil, and tadalafil.
  
  
  OBJECTIVE
  To assess patient preference for sildenafil (100 mg), vardenafil (20 mg), and tadalafil (20 mg) for the treatment of erectile dysfunction. Secondary objectives included finding out whether patients would follow treatment with a second or third option, in the event that the preferred drug was not available, and to assess side effects.
  
  
  METHODS
  Patient preference for any treatment, and evaluation of the elements that patients would assess when choosing one of these drugs.
  
  
  METHODS
  Sildenafil (100 mg), vardenafil (20 mg), and tadalafil (20 mg) were taken at least six times over a period of 45-60 days with a washout period of 7 days. A total of 132 patients were enrolled to achieve a valid sample of 90 cases (15 per randomized group, total of six groups). Enrolled patients had mild to moderate erectile function.
  
  
  RESULTS
  The International Index of Erectile Function (IIEF) score improved from baseline and was statistically significant in all cases (P < 0.0001). When we compared the IIEF scores, we found a statistically significant difference between tadalafil and vardenafil (P = 0.0002) favoring the former; similar results were obtained with the Erectile Dysfunction Inventory for Treatment Satisfaction (EDITS) Questionnaire (P = 0.000075). We also found a significant difference (P = 0.012) between tadalafil and sildenafil, again in favor of the former. In assessing drug preference, 25 patients (27.77%) chose sildenafil, 18 (20%) vardenafil, and 47 (52.22%) tadalafil. A total of 94% of patients would be willing to take another drug if the preferred choice was not available. All drugs were well tolerated.
  
  
  CONCLUSIONS
  Although this is a preference study based on subjective elements, statistically significant differences comparing the IIEF score and the EDITS Questionnaire lead us to believe that beyond patients' subjective preference per se, said preference is probably also based on a genuinely superior response to one drug over another.
authors.affiliation: Hospital Universitario de Bellvitge-Urology, L'Hospitalet, Barcelona, Spain. Electronic address: jrtol@wanadoo.es.
authors.forename: Josep Rodríguez
authors.initials: JR
authors.lastname: Tolrà
authors.affiliation: Hospital Universitario de Bellvitge-Urology, L'Hospitalet, Barcelona, Spain.
authors.forename: José María Cuadrado
authors.initials: JMC
authors.lastname: Campaña
authors.affiliation: Hospital Universitario de Bellvitge-Urology, L'Hospitalet, Barcelona, Spain.
authors.forename: Lluis Fumadó
authors.initials: LF
authors.lastname: Ciutat
authors.affiliation: Hospital Universitario de Bellvitge-Urology, L'Hospitalet, Barcelona, Spain.
authors.forename: Eladio Franco
authors.initials: EF
authors.lastname: Miranda
mesh_terms: D000368:Aged; D002243:Carbolines / Q000008:administration & dosage*; D003075:Coitus; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D007172:Erectile Dysfunction / Q000188:drug therapy*; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage*; D010879:Piperazines / Q000008:administration & dosage*; D011446:Prospective Studies; D011687:Purines; D011788:Quality of Life; D012720:Severity of Illness Index; D012725:Sexual Behavior / Q000187:drug effects; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000008:administration & dosage; D011795:Surveys and Questionnaires; D000068581:Tadalafil; D016896:Treatment Outcome; D014227:Triazines / Q000008:administration & dosage; D000069058:Vardenafil Dihydrochloride
chemical_list: D002243:Carbolines; D007093:Imidazoles; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014227:Triazines; D000069058:Vardenafil Dihydrochloride; D000068581:Tadalafil; D000068677:Sildenafil Citrate