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Endothelial Markers and Tadalafil Response

19 août 2026 mis à jour par: 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.

Aperçu de l'étude

Statut

Recrutement

Les conditions

Intervention / Traitement

Description détaillée

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.

Type d'étude

Observationnel

Inscription (Estimé)

120

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

Lieux d'étude

  • Egypte
      • Cairo, Egypte
        • Recrutement
        • Department of Urology, Al-Hussein and Sayed Galal University Hospitals, Al-Azhar University
        • Contact:

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Adulte
  • Adulte plus âgé

Accepte les volontaires sains

Non

Méthode d'échantillonnage

Échantillon non probabiliste

Population étudiée

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.

La description

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.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

Cohortes et interventions

Groupe / Cohorte
Intervention / Traitement
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.
Médicament: Tadalafil 5mg
All enrolled participants will receive tadalafil 5 mg orally once daily for 12 weeks as part of clinical management.
Autres noms:
  • Inhibiteur PDE5

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Clinical response to tadalafil at 12 weeks
Délai: 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

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Change in the International Index of Erectile Function erectile function score.
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: Baseline
Baseline biomarker levels will be evaluated as independent predictors of treatment response.
Baseline
Serum nitrite/nitrate level
Délai: Baseline
Baseline biomarker levels will be evaluated as independent predictors of treatment response.
Baseline
Serum high-sensitivity C-reactive protein
Délai: Baseline
Baseline biomarker levels will be evaluated as independent predictors of treatment response.
Baseline
Adverse events during tadalafil treatment
Délai: 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.

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Al-Azhar University

Les enquêteurs

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

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

19 août 2026

Achèvement primaire (Estimé)

1 août 2028

Achèvement de l'étude (Estimé)

1 décembre 2028

Dates d'inscription aux études

Première soumission

16 août 2026

Première soumission répondant aux critères de contrôle qualité

16 août 2026

Première publication (Réel)

19 août 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

20 août 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

19 août 2026

Dernière vérification

1 août 2026

Plus d'information

Termes liés à cette étude

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • UroAzhar_18_026

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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