COLOGNE, GERMANY, November 17, 2003 — Results of a new clinical study indicate that most men with erectile dysfunction (ED) prefer the new PDE5-inhibitor drugs to sildenafil (Viagra) and of these, nearly one-half of men prefer Levitra Online (Levitra)(1), the product most recently approved in Europe and the United States. The direct comparison study is being presented for the first time today at the 6th Congress of the European Society for Sexual Medicine (ESSM) in Istanbul.In terms of overall preference, most men rated Levitra Online as the preferred option (47%) compared with tadalafil (19%) or sildenafil (34%) at the recommended starting dose. Levitra Online was also the preferred option at the maximum dose (43% compared to 40% taldalafil, 17% sildenafil). “These findings highlight the benefit of having new alternatives to treat ED. This is one of the first studies to compare all three PDE5-inhibitors, and our initial results show that the majority of men who have tried all three drugs preferred the newer agents to sildenafil, and of these, more men preferred Levitra Online,” said Frank Sommer, MD, lead study investigator. Dr Sommer is consultant at the Department of Urology, University Medical Centre, Cologne.In the prospective, placebo-controlled, crossover multicentre study, men in a stable heterosexual relationship who had ED for 6 months received sildenafil (Viagra), tadalafil (Cialis), Levitra Online (Levitra) and placebo in a randomised sequence, with a one week wash-out period between treatments. The study consisted of two separate trials of maximum dose (100mg sildenafil, 20mg tadalafil, 20mg Levitra Online; 86 men) and recommended starting dose (50mg sildenafil, 10mg tadalafil, 10mg Levitra Online; 47 men). Efficacy was measured using benchmark International Index of Erectile Function (IIEF) and Global Assessment Questionnaire (GAQ) endpoints. Patient satisfaction and preference were also assessed. Men were also asked cite the reasons for their preference of different treatment options:
* Of those who preferred Levitra Online, the two reasons most commonly cited by patients were hardness of erection (89% at maximum dose, 90% at starting dose) and ease of getting an erection (84% at maximum dose, 86% at starting dose).
* Among those who preferred tadalafil, duration of erection was most commonly quoted (88% at maximum dose, 89% at starting dose).
* Those who preferred sildenafil, did so because of its lesser side effects (60% at maximum dose, 56% at starting dose).
All three PDE5-inhibitors were significantly more effective than placebo in achieving an erection with vaginal penetration and maintaining an erection to completion of intercourse, but Levitra Online performed better than the two other PDE5-inhibitors at both doses.”These results show that Levitra Online is preferred on the key variables necessary for success and satisfaction — ease of getting an erection and hardness of erection,” said Dr Sommer. “Physicians should consider all the available options to ensure that patients receive the treatment that best meets their needs.”
References:
(1) Sommer F, Mathers M, Klotz T et al. Which PDE5-inhibitor do patients prefer? A comparative randomised multicenter study of sildenafil, taldalafil and Levitra Online. Presented at the 6th Congress of the European Society of Sexual Medicine, Istanbul, Turkey, November 2003.
(2) Jardin A, Wagner G, Khoury S et al. Recommendations of the 1st International Consultation on Erectile Dysfunction. Co-sponsored by the World Health Organization (WHO), International Consultation on Urological Diseases (ICUD) and Societe Internationale d’Urologie (SIU) and held July 1-3, 1999, Paris. 2000, p 713.
(3) Feldman HA, Goldstein I, Hatzichristou DG et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151:54-61.
(4) Aytac IA, McKinlay JB, Krane RI. The likely worldwide increase of erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int 1999;84:50-56.
(5) Southgate J. New rivals to Viagra expand the market. Scrip World
Pharmaceutical News, 2002.
Male impotence
When a man becomes sexually aroused, increased blood flow to the genital area readies the body for intercourse. The penis becomes enlarged and erect. In men with impotence (ED,Levitra Online), however, this physical response doesn’t happen as it should. And this isn’t just a one-time or occasional occurrence. In fact, occasional failure to become aroused or desiring sex less often than your partner is perfectly normal. Stress, fatigue and anxiety can affect the body’s response to sexual stimulation. The problem occurs when this lack of response happens persistently and on a regular basis for more than 25 percent of the time. With ED, intercourse is difficult or impossible. ED is not only a common problem, particularly among older men, but also it is undertreated. The Massachusetts Male Aging Study of middle-aged and older men showed 35 percent of men ages 40 to 70 years had complete ED, which was strongly related to age, health status and emotional function. According to the American Medical Association (AMA,Levitra Online), about 20 million American men, mostly older than 65, are affected. It is difficult to calculate an exact number because less than 10 percent seek treatment.
The following information is designed as a basic introduction to possible causes of and treatments for ED. If you suspect a problem, talk with your doctor or other health care professional.
Causes
Once thought to be a psychological condition, most cases of ED are now known to have a physical cause, such as a disease, an injury or a side effect from a drug. Certain drugs can interfere with the nerve signals that cause an erection. Hardening of the arteries and high blood pressure can damage blood vessels and interfere with blood flow to the penis. Smoking is a major risk factor for these conditions as well as for ED. Diabetes can damage nerves and interfere with erection. Surgery for prostate cancer may cause ED. Other possible physical causes include alcoholism, liver failure, hormonal abnormalities (such as low testosterone,Levitra Online) and neurological disorders. In most cases of ED, even when there is also a definite physical cause, men may feel anxious, guilty or depressed, which can make the problem worse.
Treatments
The AMA estimates 95 percent of ED cases are treatable through one of the following measures.
Drug therapy: Viagra® (sildenafil,Levitra Online) was approved by the U.S. Food and Drug Administration in 1998. Taken an hour or so before sexual activity, it increases the concentration of a natural chemical in the penis that causes the blood vessels to dilate, which increases blood flow to the penis. Unlike injection therapy (see below,Levitra Onlin), it doesn’t cause an automatic erection. Rather, it works in response to sexual stimulation. However, sildenafil isn’t right for everyone. Men who have heart problems and take drugs that help widen the coronary arteries are not good candidates because the drug combination can lower blood pressure dangerously. Some men with hormonal imbalances may be helped by testosterone shots, or skin patches. In 2003 the FDA approved Levitra® (vardenafil) for the treatment of ED. The way it works is similar to sildenafil. The latest medication approved for impotence is Cialis® (tadalafil). It differs from the other two drugs only because its effects persist for 36 hours, rather than just a few hours.
Psychotherapy: Whether there is a physical cause or not, men may benefit from working with a therapist to learn techniques that can decrease anxiety associated with intercourse.Vacuum constriction device: This involves placing a plastic tube over the penis and pumping the air out of the tube, drawing blood into the penis and making it erect. An elastic band is placed around the base of the penis to maintain the erection.
Penile injection therapy: Medication injected directly into the side of the penis causes the blood vessels to widen and erection to occur.Intraurethral therapy: A soft pellet of medication is inserted into the urethra. Its absorption produces an erection.Surgery: Surgery may involve one of three procedures: implanting a device (prosthesis,Levitra Online) that can cause the penis to become erect; reconstructing arteries to increase blood flow to the penis; or repairing the veins within the penis that are failing to keep sufficient blood within the organ. Artery reconstructions and vein repairs have generally not given good long-term benefits.
All these treatments have different complications and side effects. So men should work with their doctors to determine what’s right for them.
Risk of blindness
In 2005, the Food and Drug Administration (FDA,Levitra Onlin) approved updated labeling for Cialis, Levitra and Viagra to reflect a small number of reports of sudden vision loss, attributed to NAION (non arteritic ischemic optic neuropathy), a condition where blood flow is blocked to the optic nerve. The FDA advises patients to stop taking these medicines, and call a doctor or health care provider right away if they have sudden or decreased vision loss in one or both eyes. Further, patients taking or considering taking these products should inform their health care professionals if they have ever had severe loss of vision, which might reflect a prior episode of NAION. Such patients are at an increased risk of developing NAION again.At this time, it is not possible to say if these medicines for impotence were the cause of the loss of sight or whether the problem is related to other factors such as high blood pressure or diabetes, or to a combination of these problems.
