Endothelial Markers and Tadalafil Response
Endothelial Dysfunction Markers as Predictors of Clinical Response to Daily Tadalafil in Men With Vasculogenic Erectile Dysfunction
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
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.
研究の種類
研究の種類
入学 (推定)
入学
連絡先と場所
研究連絡先
研究連絡先
- 名前:Abul-fotouh Ahmed
- 電話番号:+201001066756
- メール:abulfotouhahmed@yahoo.com
研究場所
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Cairo、エジプト
- 募集
- Department of Urology, Al-Hussein and Sayed Galal University Hospitals, Al-Azhar University
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コンタクト:
- Abul-fotouh Ahmed
- 電話番号:+201001066756
- メール:abulfotouhahmed@yahoo.com
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-
参加基準
適格基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
サンプリング方法
調査対象母集団
説明
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.
研究計画
研究はどのように設計されていますか?
デザインの詳細
グループ/コホートの数
コホートと介入
グループ/コホートグループ/コホート |
介入・治療介入・治療 |
|---|---|
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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.
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All enrolled participants will receive tadalafil 5 mg orally once daily for 12 weeks as part of clinical management.
他の名前:
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この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Clinical response to tadalafil at 12 weeks
時間枠:12 weeks
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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.
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12 weeks
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二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change in the International Index of Erectile Function erectile function score.
時間枠:Baseline to 12 weeks
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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.
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Baseline to 12 weeks
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Change in Erection Hardness Score
時間枠:Baseline and12 weeks.
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Change from baseline in the Erection Hardness Score, a 4-point scale used to assess penile rigidity during erection.
Higher scores indicate firmer erections.
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Baseline and12 weeks.
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Brachial artery flow-mediated dilatation
時間枠:Baseline
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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.
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Baseline
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Carotid intima-media thickness
時間枠:Baseline
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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.
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Baseline
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Serum endothelin-1 level
時間枠:Baseline
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Baseline biomarker levels will be evaluated as independent predictors of treatment response.
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Baseline
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Serum nitrite/nitrate level
時間枠:Baseline
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Baseline biomarker levels will be evaluated as independent predictors of treatment response.
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Baseline
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Serum high-sensitivity C-reactive protein
時間枠:Baseline
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Baseline biomarker levels will be evaluated as independent predictors of treatment response.
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Baseline
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Adverse events during tadalafil treatment
時間枠:Throughout the 12-week treatment period.
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Number and type of treatment-emergent adverse events occurring during 12 weeks of tadalafil 5 mg once-daily therapy.
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Throughout the 12-week treatment period.
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協力者と研究者
捜査官
捜査官
- 主任研究者:Abul-fotouh Ahmed、Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
研究記録日
主要日程の研究
研究開始 (実際)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- UroAzhar_18_026
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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