Effect of nebivolol on erectile function: a systematic review and meta-analysis of randomized controlled trials.

IF 3.3 3区医学 Q1 UROLOGY & NEPHROLOGY

Journal of Sexual Medicine Pub Date : 2024-12-23 DOI:10.1093/jsxmed/qdae189

Youyi Lu, Lin Li, Qi Li, Guoqin Sun

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引用次数: 0

Abstract

Background: Historically, β-blockers have been associated with erectile dysfunction (ED). Nebivolol, a third-generation β-blocker, may have had no negative effect on erectile function because of its vasodilating properties. However, the evidence level was considered either as low or very low.

Aim: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to determine the effect of nebivolol on erectile function.

Methods: All published RCTs were searched through PubMed, Cochrane Library, Web of Science, and Embase until October 2023. Review Manager version 5.3.0 was used for statistical analysis. Sensitivity analyses were performed by excluding each study using Stata 17 software.

Outcomes: The primary outcome was the International Index of Erectile Function (IIEF)-5 score. We excluded publication types, including letters, reviews, and meta-analyses.

Results: We identified four RCTs in this meta-analysis. All included studies compared the effects of nebivolol vs metoprolol on erectile function. Eight parallel groups with 397 individuals reported IIEF-5 scores. A random-effect model revealed that the IIEF-5 score was significantly higher in the nebivolol group (MD 1.81, 95%CI 0.95-2.68, P < .0001, I2 = 99%). We conducted a sensitivity analysis by removing each individual study and observed that there was no significantly different result. Furthermore, we conducted a prespecified subgroup analysis based on the dosage of metoprolol, patients with ED at the time of enrollment, and disease type. Subgroup analysis revealed that heterogeneity significantly decreased, and the result of the IIEF-5 score was stable and consistent.

Clinical implications: Our results provides stronger evidence that nebivolol significantly reduced the risk of ED occurrence or progression.

Strengths and limitations: Our meta-analysis included high-quality RCTs and conducted a predetermined subgroup analysis. However, the main limitations are the limited number of included studies and their heterogeneity.

Conclusion: Our meta-analysis provided stronger evidence that nebivolol significantly reduced the risk of ED occurrence or progression compared with metoprolol, irrespective of whether the patient had ED or not. This meta-analysis could serve as an important reference for future studies in this field.

查看原文本刊更多论文

奈比洛尔对勃起功能的影响：随机对照试验的系统回顾和荟萃分析。

背景：历史上，β受体阻滞剂与勃起功能障碍（ED）有关。Nebivolol是第三代β受体阻滞剂，由于其血管舒张特性，可能对勃起功能没有负面影响。然而，证据水平被认为是低或非常低。目的：对随机对照试验（rct）进行系统回顾和荟萃分析，以确定奈比洛尔对勃起功能的影响。方法：截至2023年10月，通过PubMed、Cochrane Library、Web of Science和Embase检索所有已发表的rct。使用Review Manager 5.3.0版本进行统计分析。敏感度分析采用Stata 17软件排除每项研究。结局：主要结局是国际勃起功能指数(IIEF)-5评分。我们排除了出版物类型，包括信件、评论和荟萃分析。结果：我们在本荟萃分析中确定了四项随机对照试验。所有纳入的研究都比较了奈比洛尔和美托洛尔对勃起功能的影响。8个平行组共397人报告了IIEF-5得分。随机效应模型显示，奈比洛尔组IIEF-5评分明显较高（MD 1.81, 95%CI 0.95-2.68， P）。临床意义：我们的结果提供了更有力的证据，证明奈比洛尔可显著降低ED发生或进展的风险。优势和局限性：我们的荟萃分析纳入了高质量的随机对照试验，并进行了预先确定的亚组分析。然而，主要的限制是纳入的研究数量有限，而且它们具有异质性。结论：我们的荟萃分析提供了更有力的证据，与美托洛尔相比，无论患者是否患有ED，纳比洛尔都能显著降低ED发生或进展的风险。本荟萃分析可为今后该领域的研究提供重要参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Sexual Medicine 医学-泌尿学与肾脏学

CiteScore

6.20

自引率

5.70%

发文量

826

审稿时长

2-4 weeks

期刊介绍： The Journal of Sexual Medicine publishes multidisciplinary basic science and clinical research to define and understand the scientific basis of male, female, and couples sexual function and dysfunction. As an official journal of the International Society for Sexual Medicine and the International Society for the Study of Women''s Sexual Health, it provides healthcare professionals in sexual medicine with essential educational content and promotes the exchange of scientific information generated from experimental and clinical research. The Journal of Sexual Medicine includes basic science and clinical research studies in the psychologic and biologic aspects of male, female, and couples sexual function and dysfunction, and highlights new observations and research, results with innovative treatments and all other topics relevant to clinical sexual medicine. The objective of The Journal of Sexual Medicine is to serve as an interdisciplinary forum to integrate the exchange among disciplines concerned with the whole field of human sexuality. The journal accomplishes this objective by publishing original articles, as well as other scientific and educational documents that support the mission of the International Society for Sexual Medicine.