Endothelial Markers and Tadalafil Response
Endothelial Dysfunction Markers as Predictors of Clinical Response to Daily Tadalafil in Men With Vasculogenic Erectile Dysfunction
Studieoversikt
Status
Status
Forhold
Forhold
Intervensjon / Behandling
Intervensjon / Behandling
Detaljert beskrivelse
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.
Studietype
Studietype
Registrering (Antatt)
Registrering
Kontakter og plasseringer
Studiekontakt
Studiekontakt
- Navn: Abul-fotouh Ahmed
- Telefonnummer: +201001066756
- E-post: abulfotouhahmed@yahoo.com
Studiesteder
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Cairo, Egypt
- Rekruttering
- Department of Urology, Al-Hussein and Sayed Galal University Hospitals, Al-Azhar University
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Ta kontakt med:
- Abul-fotouh Ahmed
- Telefonnummer: +201001066756
- E-post: abulfotouhahmed@yahoo.com
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Deltakelseskriterier
Kvalifikasjonskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
- Eldre voksen
Tar imot friske frivillige
Prøvetakingsmetode
Studiepopulasjon
Beskrivelse
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.
Studieplan
Hvordan er studiet utformet?
Designdetaljer
Antall grupper / kohorter
Kohorter og intervensjoner
Gruppe / KohortGruppe / Kohort |
Intervensjon / BehandlingIntervensjon / Behandling |
|---|---|
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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.
Andre navn:
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Hva måler studien?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Clinical response to tadalafil at 12 weeks
Tidsramme: 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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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
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Change in the International Index of Erectile Function erectile function score.
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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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Samarbeidspartnere og etterforskere
Sponsor
Sponsor
Etterforskere
Etterforskere
- Hovedetterforsker: Abul-fotouh Ahmed, Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Studiestart
Primær fullføring (Antatt)
Primær fullføring
Studiet fullført (Antatt)
Studiet fullført
Datoer for studieregistrering
Først innsendt
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Først lagt ut
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Sist oppdatering lagt ut
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
- Molekylære mekanismer for farmakologisk virkning
- Enzymhemmere
- Fosfodiesterasehemmere
- Pyridiner
- Heterocykliske forbindelser, 1-ring
- Heterocykliske forbindelser
- Heterocykliske forbindelser, 2-ring
- Heterocykliske forbindelser, smeltet ringen
- Farmakologiske handlinger
- Kjemiske handlinger og bruk
- Indoler
- Indolalkaloider
- Heterocykliske forbindelser, 3-ring
- Karboliner
- Tadalafil
- Fosfodiesterase 5-hemmere
Andre studie-ID-numre
Andre studie-ID-numre
- UroAzhar_18_026
Legemiddel- og utstyrsinformasjon, studiedokumenter
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