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Endothelial Markers and Tadalafil Response

19. August 2026 aktualisiert von: Abul-fotouh Ahmed, Al-Azhar University

Endothelial Dysfunction Markers as Predictors of Clinical Response to Daily Tadalafil in Men With Vasculogenic Erectile Dysfunction

This prospective cohort study will recruit eligible men attending the Urology/Andrology outpatient clinic. Baseline assessment will include demographic and clinical data, cardiovascular risk assessment, erectile-function questionnaires, routine laboratory investigations, brachial artery flow-mediated dilatation, carotid intima-media thickness, and selected circulating endothelial biomarkers including endothelin-1, nitrite/nitrate, high-sensitivity C-reactive protein, soluble vascular cell adhesion molecule-1, and soluble intercellular adhesion molecule-1. All participants will receive tadalafil 5 mg once daily for 12 weeks. Erectile function, adherence, and adverse events will be assessed during follow-up. The primary outcome will be clinical response at 12 weeks, defined as an improvement of at least 4 points in the IIEF-EF domain together with a positive response to the Global Assessment Question.

Studienübersicht

Status

Rekrutierung

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

Erectile dysfunction is a common male sexual disorder and is often associated with endothelial dysfunction, impaired nitric oxide bioavailability, inflammation, arterial stiffness, and subclinical atherosclerosis. Because penile arteries are relatively small, vasculogenic erectile dysfunction may appear before overt cardiovascular disease. Brachial artery flow-mediated dilatation reflects endothelial-dependent vasodilation, carotid intima-media thickness reflects structural vascular change, and circulating endothelial biomarkers may provide additional information about endothelial injury and inflammation.

This prospective observational cohort study will recruit men with predominantly vasculogenic erectile dysfunction attending the Urology/Andrology outpatient clinic. Baseline demographic, clinical, sexual, laboratory, vascular, and biomarker data will be collected before treatment. All participants will receive tadalafil 5 mg once daily for 12 weeks. Erectile function will be measured again at follow-up using the IIEF-EF domain, IIEF-5/SHIM, and the Global Assessment Question. The primary outcome is clinical response at 12 weeks, defined as an improvement of at least 4 points in IIEF-EF together with a positive Global Assessment Question response. The study will also evaluate whether baseline endothelial dysfunction markers improve prediction of tadalafil response beyond standard clinical variables.

Studientyp

Beobachtungs

Einschreibung (Geschätzt)

120

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Studienorte

      • Cairo, Ägypten
        • Rekrutierung
        • Department of Urology, Al-Hussein and Sayed Galal University Hospitals, Al-Azhar University
        • Kontakt:

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Probenahmeverfahren

Nicht-Wahrscheinlichkeitsprobe

Studienpopulation

Consecutive adult men with predominantly vasculogenic erectile dysfunction presenting to the Urology/Andrology outpatient clinic at Al-Hussein and Sayed Galal Hospitals, Al-Azhar University, Cairo, Egypt, aged 30 to 70 years and eligible for tadalafil 5 mg once daily.

Beschreibung

Inclusion Criteria:

  • Participants must fulfill all of the following:

    • Men aged 30 to 70 years.
    • ED lasting at least 3 months.
    • IIEF-5/SHIM score of 21 or less or clinically documented ED.
    • Clinical features suggesting predominantly vasculogenic ED.
    • Sexually active or willing to attempt sexual intercourse during the study.
    • Able to complete the study questionnaires.
    • Willing to take tadalafil 5 mg once daily for 12 weeks.
    • Able to provide written informed consent.
    • Willing to avoid other ED treatments during the study unless medically necessary.

Exclusion Criteria:

  • Patients will be excluded if they have:

    • ED primarily attributed to psychogenic causes.
    • Predominantly neurogenic ED.
    • Severe untreated hypogonadism likely to be the primary cause of ED.
    • Untreated hyperprolactinemia or another major endocrine disorder.
    • Significant penile anatomical abnormality interfering with intercourse, including severe Peyronie's disease.
    • Previous radical pelvic surgery or pelvic radiotherapy.
    • Active urinary or genital infection.
    • Unstable angina or unstable cardiovascular disease.
    • Recent myocardial infarction or stroke.
    • Uncontrolled hypertension or clinically significant hypotension.
    • Severe renal impairment requiring an alternative tadalafil regimen.
    • Severe hepatic impairment.
    • Active malignancy or expected survival of less than one year.
    • Major psychiatric illness, cognitive impairment or inability to comply with follow-up.
    • Current use of another PDE5 inhibitor or intracavernosal therapy that cannot be discontinued.
    • Concomitant use of organic nitrates, nitric oxide donors or nicorandil.
    • Known hypersensitivity to tadalafil.
    • Participation in another study that may affect erectile function or vascular measurements.
    • Refusal or inability to provide informed consent.

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

Kohorten und Interventionen

Gruppe / Kohorte
Intervention / Behandlung
Tadalafil 5 mg once daily
Adult men with predominantly vasculogenic erectile dysfunction who are eligible for tadalafil 5 mg once daily and enrolled in this prospective cohort study.
All enrolled participants will receive tadalafil 5 mg orally once daily for 12 weeks as part of clinical management.
Andere Namen:
  • PDE5-Hemmer

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Clinical response to tadalafil at 12 weeks
Zeitfenster: 12 weeks
Proportion of participants achieving clinical response, defined as an increase of at least 4 points in the IIEF-EF domain score from baseline together with a positive response to the Global Assessment Question. The IIEF-EF domain scores erectile function on a higher-is-better scale; higher scores indicate better erectile function.
12 weeks

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Change in the International Index of Erectile Function erectile function score.
Zeitfenster: Baseline to 12 weeks
Change from baseline in the erectile function domain of the International Index of Erectile Function (IIEF-EF). The IIEF-EF domain is a validated erectile function score, with higher values indicating better erectile function.
Baseline to 12 weeks
Change in Erection Hardness Score
Zeitfenster: Baseline and12 weeks.
Change from baseline in the Erection Hardness Score, a 4-point scale used to assess penile rigidity during erection. Higher scores indicate firmer erections.
Baseline and12 weeks.
Brachial artery flow-mediated dilatation
Zeitfenster: Baseline
Association between baseline brachial artery flow-mediated dilatation percentage and clinical response to tadalafil. Flow-mediated dilatation is a functional ultrasound-based measure of endothelial-dependent vasodilation; lower values indicate worse endothelial function. Baseline FMD will be evaluated as an independent predictor of treatment response.
Baseline
Carotid intima-media thickness
Zeitfenster: Baseline
Association between baseline mean carotid intima-media thickness and clinical response to tadalafil. Carotid intima-media thickness is a structural ultrasound marker of subclinical atherosclerosis; higher values indicate more advanced vascular wall thickening. Baseline CIMT will be evaluated as an independent predictor of treatment response.
Baseline
Serum endothelin-1 level
Zeitfenster: Baseline
Baseline biomarker levels will be evaluated as independent predictors of treatment response.
Baseline
Serum nitrite/nitrate level
Zeitfenster: Baseline
Baseline biomarker levels will be evaluated as independent predictors of treatment response.
Baseline
Serum high-sensitivity C-reactive protein
Zeitfenster: Baseline
Baseline biomarker levels will be evaluated as independent predictors of treatment response.
Baseline
Adverse events during tadalafil treatment
Zeitfenster: Throughout the 12-week treatment period.
Number and type of treatment-emergent adverse events occurring during 12 weeks of tadalafil 5 mg once-daily therapy.
Throughout the 12-week treatment period.

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Ermittler

  • Hauptermittler: Abul-fotouh Ahmed, Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

19. August 2026

Primärer Abschluss (Geschätzt)

1. August 2028

Studienabschluss (Geschätzt)

1. Dezember 2028

Studienanmeldedaten

Zuerst eingereicht

16. August 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

16. August 2026

Zuerst gepostet (Tatsächlich)

19. August 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

20. August 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

19. August 2026

Zuletzt verifiziert

1. August 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • UroAzhar_18_026

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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