PMID- 30096166
OWN - NLM
STAT- MEDLINE
DCOM- 20190204
LR  - 20190215
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 13
IP  - 8
DP  - 2018
TI  - Multiple PDE5Is use as a marker of decreased overall men's health: A real-life
      study.
PG  - e0201601
LID - 10.1371/journal.pone.0201601 [doi]
AB  - Erectile dysfunction (ED) is considered a sentinel marker for poor general men's 
      health status. Severe ED has been associated with poor response to
      phosphodiesterase type 5 inhibitors (PDE5Is) therapy. We sought to assess the
      association of multiple PDE5Is prescription with the overall patients' health
      status. Socio-demographic and clinical variables from 939 consecutive
      white-European, heterosexual, sexually-active men seeking medical help for ED at 
      same tertiary-referral academic outpatient clinic were analyzed.
      Health-significant comorbidities were scored with the Charlson Comorbidity Index 
      (CCI). Patients have been stratified into naive and non-naive according to their 
      history of previous prescriptions of any PDE5I. Every patient completed the
      International Index of Erectile Function (IIEF) questionnaire. Logistic
      regression models tested the association between patients' baseline
      characteristics (thus including previous PDE5Is prescriptions) and the overall
      health status. Overall, 328 (35%) patients were non-naive for PDE5Is. Of them,
      172 (52%), 99 (30%), and 57 (17%) had been prescribed with 1, 2 or 3 different
      PDE5Is, respectively. Naive and non-naive patients did not differ in terms of
      age, BMI, baseline ED severity; conversely, non-naive patients had a higher CCI
      score. At logistic MVA, the number of PDE5Is prescriptions emerged as an
      independent predictor of a higher burden of comorbidities regardless of ED
      severity; the higher the number of PDE5Is prescriptions, the higher the CCI score
      (OR 1.69, 2.49, and 2.90 for 1, 2 or 3 previous PDE5Is, respectively), after
      accounting for age, BMI, baseline ED severity and cigarette smoking. More than a 
      third of patients seeking medical help for ED at a single tertiary-referral
      center were non-naive for PDE5Is. The increasing number of previous prescriptions
      of PDE5Is emerged as a worrisome marker of a poorer overall men's health status
      regardless of ED severity.
FAU - Oreggia, Davide
AU  - Oreggia D
AD  - University Vita-Salute San Raffaele, Milan, Italy.
AD  - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San
      Raffaele, Milan, Italy.
FAU - Ventimiglia, Eugenio
AU  - Ventimiglia E
AD  - University Vita-Salute San Raffaele, Milan, Italy.
AD  - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San
      Raffaele, Milan, Italy.
FAU - Capogrosso, Paolo
AU  - Capogrosso P
AUID- ORCID: 0000-0003-2347-9504
AD  - University Vita-Salute San Raffaele, Milan, Italy.
AD  - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San
      Raffaele, Milan, Italy.
FAU - Boeri, Luca
AU  - Boeri L
AD  - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San
      Raffaele, Milan, Italy.
AD  - Department of Urology, University of Milan, Milan, Italy.
FAU - Cazzaniga, Walter
AU  - Cazzaniga W
AD  - University Vita-Salute San Raffaele, Milan, Italy.
AD  - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San
      Raffaele, Milan, Italy.
FAU - Pederzoli, Filippo
AU  - Pederzoli F
AD  - University Vita-Salute San Raffaele, Milan, Italy.
AD  - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San
      Raffaele, Milan, Italy.
FAU - Chierigo, Francesco
AU  - Chierigo F
AD  - University Vita-Salute San Raffaele, Milan, Italy.
AD  - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San
      Raffaele, Milan, Italy.
FAU - Deho, Federico
AU  - Deho F
AD  - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San
      Raffaele, Milan, Italy.
FAU - Montorsi, Francesco
AU  - Montorsi F
AD  - University Vita-Salute San Raffaele, Milan, Italy.
AD  - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San
      Raffaele, Milan, Italy.
FAU - Salonia, Andrea
AU  - Salonia A
AD  - University Vita-Salute San Raffaele, Milan, Italy.
AD  - Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San
      Raffaele, Milan, Italy.
LA  - eng
PT  - Journal Article
DEP - 20180810
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Phosphodiesterase 5 Inhibitors)
SB  - IM
MH  - Adult
MH  - *Comorbidity
MH  - Erectile Dysfunction/*drug therapy
MH  - Health Status
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - *Men's Health
MH  - Middle Aged
MH  - Phosphodiesterase 5 Inhibitors/*adverse effects/therapeutic use
MH  - Reproductive Health
MH  - Tertiary Care Centers
PMC - PMC6086394
COIS- The authors have declared that no competing interests exist.
EDAT- 2018/08/11 06:00
MHDA- 2019/02/05 06:00
CRDT- 2018/08/11 06:00
PHST- 2017/12/04 00:00 [received]
PHST- 2018/06/20 00:00 [accepted]
PHST- 2018/08/11 06:00 [entrez]
PHST- 2018/08/11 06:00 [pubmed]
PHST- 2019/02/05 06:00 [medline]
AID - 10.1371/journal.pone.0201601 [doi]
AID - PONE-D-17-42553 [pii]
PST - epublish
SO  - PLoS One. 2018 Aug 10;13(8):e0201601. doi: 10.1371/journal.pone.0201601.
      eCollection 2018.