Efficacy and safety of simenafil in men with erectile dysfunction: a multicenter, randomized, double-blind, placebo-controlled, fixed dose, parallel group, phase 3 trial.
{"title":"Efficacy and safety of simenafil in men with erectile dysfunction: a multicenter, randomized, double-blind, placebo-controlled, fixed dose, parallel group, phase 3 trial.","authors":"Yuzhuo Yang, Xiansheng Zhang, Tao Jiang, Lianming Zhao, Fubiao Li, Wenliang Yao, Junhong Deng, Xiangsheng Zhang, Jin Yang, Zhigang Ji, Zhigang Tong, Yun Chen, Zhen Wang, Jiaxiang Juan, Huaqing Duan, Hui Jiang","doi":"10.1093/jsxmed/qdaf109","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Simenafil, a potent and highly selective oral phosphodiesterase type 5 (PDE5) inhibitor, is currently under investigation for erectile dysfunction (ED) treatment.</p><p><strong>Aims: </strong>To evaluate the efficacy and safety of simenafil for ED treatment.</p><p><strong>Methods: </strong>This was a multicenter, randomized, double-blind, placebo-controlled, parallel group, phase 3 study in men aged 18-75 years with a history of ED of 6 months or more. The subjects were randomized in a ratio of 1:1:1:1 to on-demand receive fixed-dose either placebo or simenafil (2.5 mg, 5 mg or 10 mg) for 12 weeks.</p><p><strong>Outcomes: </strong>Primary efficacy endpoints were the least square mean (LSM) changes from baseline to week 12 in the erectile function (EF) domain of the International Index of Erectile Function (IIEF), percentages of \"yes\" responses to sexual encounter profile (SEP) diary question 2 (SEP Q2: Were you able to insert your penis into your partner's vagina?) and question 3 (SEP Q3: Did your erection last long enough for you to have successful intercourse?).</p><p><strong>Results: </strong>A total of 765 patients were randomized and 92.3% completed the study. The mean age of subjects was 41.3 years and 81.6% had moderate to severe ED (mean overall International Index of Erectile Function-Erectile Function (IIEF-EF) domain score 13.4). After 12 weeks of treatment, doses of 2.5, 5, and 10 mg of simenafil exhibited substantial increases than placebo in IIEF-EF score (12.3, 12.3, 12.7 vs. 9.6), the percentages of \"yes\" responses to SEP Q2 (40.58%, 42.43%, 43.98% vs. 32.05%), and SEP Q3 (61.91%, 63.70%, 65.19% vs. 46.70%) (all P < .001). Adverse drug reactions (ADRs) occurred in 36.2% of patients who received simenafil (32.6% in simenafil 5 mg group, the clinically recommended dose) and in 30.9% of those who received placebo. The most common (≥2%) ADRs were dizziness, headache, flushing, nasal congestion, and dry mouth, and most were mild or moderate. Furthermore, abnormal vision (PDE6 related) and myalgia (PDE11 related) did not occur in patients who received simenafil.</p><p><strong>Clinical implications: </strong>Simenafil is highly effective in all 3 dose groups and has a low effective dose and good safety profile, providing a novel, favorable treatment option for patients with ED.</p><p><strong>Strengths and limitations: </strong>The efficacy and safety evaluation of simenafil in difficult-to-treat patients with ED, ED patients with other concomitant diseases, and other ethnic populations was not performed.</p><p><strong>Conclusion: </strong>Simenafil is an effective and well-tolerated therapy for patients with ED.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Sexual Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jsxmed/qdaf109","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Simenafil, a potent and highly selective oral phosphodiesterase type 5 (PDE5) inhibitor, is currently under investigation for erectile dysfunction (ED) treatment.
Aims: To evaluate the efficacy and safety of simenafil for ED treatment.
Methods: This was a multicenter, randomized, double-blind, placebo-controlled, parallel group, phase 3 study in men aged 18-75 years with a history of ED of 6 months or more. The subjects were randomized in a ratio of 1:1:1:1 to on-demand receive fixed-dose either placebo or simenafil (2.5 mg, 5 mg or 10 mg) for 12 weeks.
Outcomes: Primary efficacy endpoints were the least square mean (LSM) changes from baseline to week 12 in the erectile function (EF) domain of the International Index of Erectile Function (IIEF), percentages of "yes" responses to sexual encounter profile (SEP) diary question 2 (SEP Q2: Were you able to insert your penis into your partner's vagina?) and question 3 (SEP Q3: Did your erection last long enough for you to have successful intercourse?).
Results: A total of 765 patients were randomized and 92.3% completed the study. The mean age of subjects was 41.3 years and 81.6% had moderate to severe ED (mean overall International Index of Erectile Function-Erectile Function (IIEF-EF) domain score 13.4). After 12 weeks of treatment, doses of 2.5, 5, and 10 mg of simenafil exhibited substantial increases than placebo in IIEF-EF score (12.3, 12.3, 12.7 vs. 9.6), the percentages of "yes" responses to SEP Q2 (40.58%, 42.43%, 43.98% vs. 32.05%), and SEP Q3 (61.91%, 63.70%, 65.19% vs. 46.70%) (all P < .001). Adverse drug reactions (ADRs) occurred in 36.2% of patients who received simenafil (32.6% in simenafil 5 mg group, the clinically recommended dose) and in 30.9% of those who received placebo. The most common (≥2%) ADRs were dizziness, headache, flushing, nasal congestion, and dry mouth, and most were mild or moderate. Furthermore, abnormal vision (PDE6 related) and myalgia (PDE11 related) did not occur in patients who received simenafil.
Clinical implications: Simenafil is highly effective in all 3 dose groups and has a low effective dose and good safety profile, providing a novel, favorable treatment option for patients with ED.
Strengths and limitations: The efficacy and safety evaluation of simenafil in difficult-to-treat patients with ED, ED patients with other concomitant diseases, and other ethnic populations was not performed.
Conclusion: Simenafil is an effective and well-tolerated therapy for patients with ED.
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.