PMID- 31043704 OWN - NLM STAT- MEDLINE DCOM- 20210215 LR - 20210215 IS - 1476-5489 (Electronic) IS - 0955-9930 (Linking) VI - 32 IP - 4 DP - 2020 Jul TI - Undiagnosed prediabetes status is associated with a reduced effectiveness of phosphodiesterase type 5 inhibitors in men with erectile dysfunction. PG - 393-400 LID - 10.1038/s41443-019-0149-4 [doi] AB - The efficacy of phosphodiesterase type 5 inhibitors (PDE5i) in patients with erectile dysfunction (ED) and undiagnosed prediabetes (PreDM) has been scantly analysed. We aimed to assess rates of and predictors of response to oral treatment in a cohort of ED men naive for PDE5i with either normo-glycaemia or PreDM or diabetes mellitus (DM). Complete data from 466 men were analysed. Comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients completed the International Index of Erectile Function (IIEF) at baseline and after 3 months of PDE5i treatment. Treatment response was evaluated using the minimal clinically important difference (MCID) (mild: +2; moderate: +5; severe: +7 from baseline IIEF-EF). PreDM status was defined as for the American Diabetes Association (2015) criteria. Descriptive statistics and logistic regression models tested the association between clinical predictors and MCID response. Overall, 253 (56.7%), 105 (23.5%) and 88 (19.7%) patients had normo-glycaemia (=controls), PreDM and DM, respectively. Diabetic and PreDM men were older, had higher BMI, higher CCI scores and lower total testosterone (tT) (all p < 0.01) compared to controls. Median baseline IIEF-EF was lower both in PreDM (14.0 vs. 18.0; p < 0.05) and DM patients (10.0 vs. 18.0; p < 0.001) than in controls. IIEF-EF improved in all groups after treatment (all p < 0.001), but scores were higher in controls compared to both PreDM and DM men at 3-mos assessment (26.0 vs. 20.0 vs. 17.5, respectively; all p < 0.001). Controls more frequently achieved significant MCID than both PreDM and DM patients (65.3 vs. 22.9 vs. 11.8%, respectively; p < 0.01). Age (p < 0.001), baseline IIEF-EF (p < 0.001), and DM status (p = 0.02) were independently associated with MCID. In conclusion, patients with undiagnosed PreDM depicted lower rates of response to PDE5i than normoglycemic men. These findings suggest that even milder forms of glucose impairment are associated with a poorer PDE5i effectiveness in men with ED. FAU - Boeri, Luca AU - Boeri L AD - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20131, Milan, Italy. AD - Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, 20122, Milan, Italy. FAU - Capogrosso, Paolo AU - Capogrosso P AD - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20131, Milan, Italy. AD - University Vita-Salute San Raffaele, 20131, Milan, Italy. FAU - Ventimiglia, Eugenio AU - Ventimiglia E AD - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20131, Milan, Italy. AD - University Vita-Salute San Raffaele, 20131, Milan, Italy. FAU - Pozzi, Edoardo AU - Pozzi E AD - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20131, Milan, Italy. AD - University Vita-Salute San Raffaele, 20131, Milan, Italy. FAU - Chierigo, Francesco AU - Chierigo F AUID- ORCID: 0000-0001-7357-0758 AD - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20131, Milan, Italy. AD - University Vita-Salute San Raffaele, 20131, Milan, Italy. FAU - Belladelli, Federico AU - Belladelli F AD - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20131, Milan, Italy. AD - University Vita-Salute San Raffaele, 20131, Milan, Italy. FAU - Zuabi, Rani AU - Zuabi R AD - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20131, Milan, Italy. AD - University Vita-Salute San Raffaele, 20131, Milan, Italy. FAU - Schifano, Nicolo AU - Schifano N AD - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20131, Milan, Italy. AD - University Vita-Salute San Raffaele, 20131, Milan, Italy. FAU - Abbate, Costantino AU - Abbate C AD - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20131, Milan, Italy. FAU - Deho, Federico AU - Deho F AD - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20131, Milan, Italy. FAU - Montanari, Emanuele AU - Montanari E AD - Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, 20122, Milan, Italy. FAU - Montorsi, Francesco AU - Montorsi F AD - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20131, Milan, Italy. AD - University Vita-Salute San Raffaele, 20131, Milan, Italy. FAU - Salonia, Andrea AU - Salonia A AD - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20131, Milan, Italy. salonia.andrea@hsr.it. AD - University Vita-Salute San Raffaele, 20131, Milan, Italy. salonia.andrea@hsr.it. LA - eng PT - Journal Article DEP - 20190501 PL - England TA - Int J Impot Res JT - International journal of impotence research JID - 9007383 RN - 0 (Phosphodiesterase 5 Inhibitors) RN - 3XMK78S47O (Testosterone) SB - IM MH - Cohort Studies MH - *Erectile Dysfunction/diagnosis/drug therapy MH - Humans MH - Male MH - *Phosphodiesterase 5 Inhibitors/therapeutic use MH - *Prediabetic State/complications/diagnosis/drug therapy MH - Testosterone EDAT- 2019/05/03 06:00 MHDA- 2021/02/16 06:00 CRDT- 2019/05/03 06:00 PHST- 2019/01/14 00:00 [received] PHST- 2019/03/05 00:00 [accepted] PHST- 2019/02/17 00:00 [revised] PHST- 2019/05/03 06:00 [pubmed] PHST- 2021/02/16 06:00 [medline] PHST- 2019/05/03 06:00 [entrez] AID - 10.1038/s41443-019-0149-4 [pii] AID - 10.1038/s41443-019-0149-4 [doi] PST - ppublish SO - Int J Impot Res. 2020 Jul;32(4):393-400. doi: 10.1038/s41443-019-0149-4. Epub 2019 May 1.