SynthesisWorld journal of urology2021
Efficacy and safety of oral phosphodiesterase 5 inhibitors for erectile dysfunction: a network meta-analysis and multicriteria decision analysis.
Synthesis in World journal of urology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 54 citations in OpenAlex.
- Trial
- Effect of Huashi Tongbi Formula on Erectile Dysfunction with Damp Heat Affecting Pi (Spleen) Pattern: A Multicentre, Randomized, Controlled Noninferiority Trial.Chinese journal of integrative medicine · 2026Trial
- Apparent Non-Response to Phosphodiesterase Type 5 Inhibitors in Erectile Dysfunction: A Narrative Review of Structured Reassessment and Management.Medicina (Kaunas, Lithuania) · 2026Review
- Spinal Cord Injury-Related Male Infertility: Oxidative Stress, Inflammation, and Sperm DNA Damage.Journal of clinical medicine · 2026Review
- Guideline of guidelines: a scoping review on comparison of major clinical guidelines for erectile dysfunction.Translational andrology and urology · 2026Review
- Erectile Dysfunction: A Comprehensive Review of Pathophysiology, Diagnosis and Contemporary Management.Medicina (Kaunas, Lithuania) · 2026Review
- Vardenafil in the multidisciplinary management of erectile dysfunction: a narrative review on multidimensional outcomes and clinical integration.World journal of urology · 2026Review
- Oral suspension versus tablet sildenafil for erectile dysfunction: a prospective multicenter comparative study on patient satisfaction.International journal of impotence research · 2026Article
- The role of sleep stages in the regulation of erectile function: impacts of REM sleep fragmentation.International journal of impotence research · 2026Review
- Quercetin alleviates radiation-induced erectile dysfunction by modulating oxidative stress and apoptosis through the Nrf2/HO-1 pathway.European journal of medical research · 2026Article
- Gaps in diagnosis and unmet healthcare needs in male sexual dysfunction and chronic health conditions: insights from a German population-based study.Basic and clinical andrology · 2025Article
- Bedtime sildenafil oral suspension improves sexual spontaneity and time-concerns compared to on-demand treatment in men with erectile dysfunction: results from a real-life, cross-sectional study.International journal of impotence research · 2025Article
- Sildenafil oral suspension formulation for erectile dysfunction: is it love at first sight?International journal of impotence research · 2025Article
- Effectiveness and patient satisfaction with the new sildenafil oral suspension formulation compared to sildenafil oro-dispersible film: a real-life study.International journal of impotence research · 2025Article
- Beyond the prescription: trends and challenges in erectile dysfunction medications among young adult men.International journal of impotence research · 2025Article
- Antioxidant Supplementation for Erectile Dysfunction: Systematic Review and Meta-Analysis of Double-Blind, Randomized, Placebo-Controlled Trials.The world journal of men's health · 2025Article
- Phosphodiesterases: Evolving Concepts and Implications for Human Therapeutics.Annual review of pharmacology and toxicology · 2025Review
- Carvacrol prevents D-( +)-galactose-induced aging-associated erectile dysfunction by improving endothelial dysfunction and oxidative stress in rats.Naunyn-Schmiedeberg's archives of pharmacology · 2024Article
- Article
- Oxidative Stress and Erectile Dysfunction: Pathophysiology, Impacts, and Potential Treatments.Current issues in molecular biology · 2024Review
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo quantitatively assess the benefit-risk ratio on the efficacy and safety of all phosphodiesterase type 5 inhibitors (PDE5i) in men with erectile dysfunction.
methodsA systematic review with network meta-analysis, surface under the cumulative ranking analysis and stochastic multicriteria acceptability analyses were performed. Searches were conducted in Pubmed, Scopus, Web of Science without limits for time-frame or language. Randomized controlled trials evaluating the efficacy or safety of any PDE5i compared to a placebo or to other PDE5i in males with erectile disfunction were included.
resultsOverall, 184 articles representing 179 randomized controlled trials (50,620 patients) were included. All PDE5i were significantly more efficient than placebo. Sildenafil 25 mg was statistically superior to all interventions in enhancing IIEF (with a 98% probability of being the most effective treatment), followed by sildenafil 50 mg (80% of probability). Taladafil 10 mg and 20 mg also presented good profiles (73% and 76%, respectively). Avanafil and lodenafil were less effective interventions. Mirodenafil 150 mg was the treatment that caused more adverse events, especially flushing and headaches. Sildenafil 100 mg was more related to visual disorders, while vardenafil and udenafil were more prone to cause nasal congestion.
conclusionSildenafil at low doses and tadalafil should be the first therapeutic options. Avanafil, lodenafil and mirodenafil use are hardly justified given the lack of expressive efficacy or high rates of adverse events.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.