PMID- 30544399
OWN - NLM
STAT- MEDLINE
DCOM- 20181227
LR  - 20231005
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 49
DP  - 2018 Dec
TI  - Comparative efficacy and safety of phosphodiesterase-5 inhibitors with selective 
      serotonin reuptake inhibitors in men with premature ejaculation: A systematic 
      review and Bayesian network meta-analysis.
PG  - e13342
LID - 10.1097/MD.0000000000013342 [doi]
LID - e13342
AB  - BACKGROUND: We performed the network meta-analysis (NMA) and systematic review 
      involved all evidence from relevant trials to compare the efficiency and safety 
      of various types of selective serotonin reuptake inhibitors (SSRI) and 
      phosphodiesterase-5 inhibitors (PDE5i) in patients with premature ejaculation 
      (PE). METHODS: We conducted comprehensive searches of peer-reviewed and grey 
      literature. PubMed, the Cochrane Library Central Register of Controlled Trials, 
      Embase were searched for randomized controlled trials published up to June 1, 
      2017. The primary outcome was intravaginal ejaculation latency time (IVELT) and 
      adverse effects (AEs). We performed pairwise meta-analyses by random effects 
      model and network meta-analysis by Bayesian model. We used the GRADE framework to 
      assess the quality of evidence contributing to each network estimate. RESULTS: Of 
      3046 titles and abstracts initially identified, 17 trials reporting 5739 
      participants were included. Considering IVELT in the NMA, paroxetine plus 
      sildenafil and sildenafil alone are both superior to placebo (MD: 1.75, 95% CrI: 
      0.05 to 3.78; MD 1.43, 95% CrI 0.003 to 2.81). Sildenafil is superior to 
      sertraline (MD: 1.63, 95% CrI: 0.10 to 2.79). Considering AEs, placebo 
      demonstrated obviously lower risk comparing to paroxetine, sildenafil and 
      paroxetine plus sildenafil (OR 0.20, 95% CI: 0.05 to 0.52; OR 0.23, 95% CI: 0.04 
      to 0.80; OR 0.45, 95% CI: 0.01 to 0.92). Compared with tadalafil plus paroxetine, 
      dapoxetine showed significantly less AEs (OR 0.23, 95% CI 0.02 to 0.96). 
      CONCLUSIONS: Our study concluded that although paroxetine plus sildenafil and 
      sildenafil alone both demonstrated significant IVELT benefit compared with 
      placebo, significant increase of AEs risk was also observed. Furthermore, 
      sildenafil alone was superior to sertraline in efficacy with comparable 
      tolerability.
FAU - Jin, Kun
AU  - Jin K
AD  - Department of Urology, Institute of Urology, West China Hospital of Sichuan 
      University.
FAU - Deng, Linghui
AU  - Deng L
AD  - Stroke Clinical Research Unit, Department of Neurology, West China Hospital of 
      Sichuan University, Chengdu, Sichuan, PR China.
FAU - Qiu, Shi
AU  - Qiu S
AD  - Department of Urology, Institute of Urology, West China Hospital of Sichuan 
      University.
FAU - Tu, Xiang
AU  - Tu X
AD  - Department of Urology, Institute of Urology, West China Hospital of Sichuan 
      University.
FAU - Li, Jiakun
AU  - Li J
AD  - Department of Urology, Institute of Urology, West China Hospital of Sichuan 
      University.
FAU - Bao, Yige
AU  - Bao Y
AD  - Department of Urology, Institute of Urology, West China Hospital of Sichuan 
      University.
FAU - Yang, Lu
AU  - Yang L
AD  - Department of Urology, Institute of Urology, West China Hospital of Sichuan 
      University.
FAU - Wei, Qiang
AU  - Wei Q
AD  - Department of Urology, Institute of Urology, West China Hospital of Sichuan 
      University.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Phosphodiesterase 5 Inhibitors)
RN  - 0 (Serotonin Uptake Inhibitors)
SB  - IM
MH  - Bayes Theorem
MH  - Humans
MH  - Male
MH  - Phosphodiesterase 5 Inhibitors/adverse effects/*therapeutic use
MH  - Premature Ejaculation/*drug therapy
MH  - Selective Serotonin Reuptake Inhibitors/adverse effects/*therapeutic use
PMC - PMC6310608
COIS- The authors have no conflicts of interest to disclose. Provenance and peer review 
      Not commissioned; externally peer reviewed.
EDAT- 2018/12/14 06:00
MHDA- 2018/12/28 06:00
PMCR- 2018/12/10
CRDT- 2018/12/15 06:00
PHST- 2018/12/15 06:00 [entrez]
PHST- 2018/12/14 06:00 [pubmed]
PHST- 2018/12/28 06:00 [medline]
PHST- 2018/12/10 00:00 [pmc-release]
AID - 00005792-201812070-00034 [pii]
AID - MD-D-18-03713 [pii]
AID - 10.1097/MD.0000000000013342 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Dec;97(49):e13342. doi: 10.1097/MD.0000000000013342.