Efficacy and safety of PDE5 inhibitors in the treatment of diabetes mellitus erectile dysfunction: a systematic review and meta-analysis

Abstract ABSTRACT Background: To systematically evaluate the efficacy and safety of the PDE5 inhibitors in patients with diabetes mellitus erectile dysfunction (DMED). Methods: Random control trials (RCTs) in PubMed, EMBASE, Cochrane library, ClinicalTrials, China Knowledge Network (CNKI), Weipu Chinese Science and Technology Journal Full-text Database (VIP), Wanfang Data Resource System (WANFANG) were searched. Two researchers independently screened the literature, extracted the data and checked the results, and used the risk assessment tool to conduct a methodological quality assessment, and finally conducted a meta-analysis. The primary outcome, the erectile function scores of the International Index of Erectile Dysfunction (IIEF-EF), was recorded, while secondary outcomes (IIEF-Q3, IIEF-Q4, SEP 2 and 3, GAQ) and safety outcomes also needed attention. Results: Twelve studies included 3,124 patients and six PDE5 inhibitors were included. Compared with placebo, PDE5 inhibitors significantly improved male erectile function in IIEF-EF (WMD = 5.73; 95% CI: 3.62 to 7.84), IIEF-Q3 (WMD = 1.14; 95% CI: 0.87 to 1.40), IIEF-Q4 (WMD=1.28; 95% CI: 1.04 to 1.51), SEP2 (WMD=21.24; 95% CI: 15.50 to 26.98), SEP3 (WMD=25.77; 95% CI: 18.78 to 32.77), GAQ (RR) =2.98; 95% CI: 2.06 to 4.32), and with the safety (WMD=5.73; 95% CI: 3.62 to 7.84). Conclusions: PDE5 inhibitors can significantly improve the patient's erectile function, but cannot ignore their side effects.