The safety and efficacy of phosphodiesterase type 5 inhibitors in the treatment of diabetic erectile dysfunction: a systematic review and meta-analysis.

IF 2.4 3区 生物学 Q2 MULTIDISCIPLINARY SCIENCES
PeerJ Pub Date : 2025-10-07 eCollection Date: 2025-01-01 DOI:10.7717/peerj.20147
Zexin Zhu, Jian Xu, Bo Dai, Minghao Lin, Huhu Yang, Shilin Liu, Pengjie Bao, Zheng Nan
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引用次数: 0

Abstract

Background: Previous studies have confirmed the efficacy of phosphodiesterase type 5 inhibitors (PDE-5 inhibitors) in treating diabetic erectile dysfunction (DED), but they still have research value in terms of efficacy comparison and individualized safety. This study, while evaluating safety and efficacy, also focused on the sources of heterogeneity and innovatively explored the nonlinear relationship between therapeutic effect and age.

Aim: This study aimed to systematically evaluate the safety and efficacy of PDE-5 inhibitors for the treatment of DED and the related application effects and to provide a clinical basis for its treatment.

Methods: By searching PubMed, Embase, Web Of Science, Cochrane Library, China Knowledge Network (CNKI), Wipro (VIP), Wanfang, and China Biomedical Literature Database (CBM) before December 31, 2024, and reading the retrieved articles and references, PDE-5 inhibitors for diabetic erectile dysfunction in randomized controlled trials (RCTs). The literature of the included studies was evaluated using the Cochrane Literature Quality Assessment Tool. The meta-analysis was registered to PROSPERO (CRD42025637725).

Outcomes: The International Index of Erectile Function (IIEF-5) overall and related evaluation questionnaires were used as the primary efficacy evaluation indicators, and adverse events were used as secondary indicators.

Results: Meta-analysis was performed using Rever Manager 5.3 and STATA18 software. A total of 10 studies were included, and random-effects model meta-analysis analyzed the post-treatment efficacy of the 10 articles with a combined RR = 2.91, 95% CI of [1.95-4.34], P < 0.001. Fixed-effects model meta-analysis investigated adverse effects with RR = 2.0, 95% CI of [1.53-2.61], P < 0.001. There was a non-linear relationship between age and PDE-5 inhibitors.

Conclusion: PDE-5 inhibitors can safely and effectively improve diabetic erectile dysfunction, but the degree of effectiveness of different types of drugs, the occurrence of related adverse effects, and the differences that exist between individuals still need to be taken into account during use.

磷酸二酯酶5型抑制剂治疗糖尿病勃起功能障碍的安全性和有效性:一项系统综述和荟萃分析。
背景:前期研究已证实磷酸二酯酶5型抑制剂(PDE-5 inhibitors)治疗糖尿病性勃起功能障碍(DED)的疗效,但在疗效比较和个体化安全性方面仍有研究价值。本研究在评价安全性和有效性的同时,也关注异质性的来源,创新性地探讨了治疗效果与年龄的非线性关系。目的:本研究旨在系统评价PDE-5抑制剂治疗DED的安全性、有效性及相关应用效果,为其治疗提供临床依据。方法:在2024年12月31日前检索PubMed、Embase、Web Of Science、Cochrane Library、中国知网(CNKI)、Wipro (VIP)、万方、中国生物医学文献数据库(CBM),并阅读检索到的文章和参考文献,PDE-5抑制剂治疗糖尿病性勃起功能障碍的随机对照试验(RCTs)。采用Cochrane文献质量评估工具对纳入研究的文献进行评价。meta分析注册到PROSPERO (CRD42025637725)。结果:以国际勃起功能指数(IIEF-5)总分及相关评价问卷作为主要疗效评价指标,不良事件作为次要评价指标。结果:采用Rever Manager 5.3和STATA18软件进行meta分析。共纳入10篇研究,随机效应模型荟萃分析10篇文献的治疗后疗效,合并RR = 2.91, 95% CI为[1.95 ~ 4.34],P < 0.001。固定效应模型荟萃分析调查不良反应,RR = 2.0, 95% CI为[1.53-2.61],P < 0.001。年龄与PDE-5抑制剂之间存在非线性关系。结论:PDE-5抑制剂可以安全有效地改善糖尿病性勃起功能障碍,但不同类型药物的有效程度、相关不良反应的发生情况以及个体间存在的差异仍需在使用时加以考虑。
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来源期刊
PeerJ
PeerJ MULTIDISCIPLINARY SCIENCES-
CiteScore
4.70
自引率
3.70%
发文量
1665
审稿时长
10 weeks
期刊介绍: PeerJ is an open access peer-reviewed scientific journal covering research in the biological and medical sciences. At PeerJ, authors take out a lifetime publication plan (for as little as $99) which allows them to publish articles in the journal for free, forever. PeerJ has 5 Nobel Prize Winners on the Board; they have won several industry and media awards; and they are widely recognized as being one of the most interesting recent developments in academic publishing.
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