Selective phosphodiesterase type 5 inhibition using tadalafil for the treatment of erectile dysfunction
Bibliographic record
Abstract
Erectile dysfunction (ED) pharmacotherapy has undergone dramatic advances over the past decade, since the introduction of phosphodiesterase type 5 inhibitors (PDE5). The availability of an oral agent, sildenafil, able to restore erectile function in the majority of men with an organic basis to their dysfunction, transformed the management. The numbers of men seeking medical attention for ED, along with the increased comfort of physicians treating it, has resulted in enhanced management of this condition. In spite of these advances, there exist a significant number of men who remain unsuccessfully treated with sildenafil. Development of new PDE5 inhibitors, with the promise of enhanced selectivity, longer duration of action, increased potency and greater ease of use are currently in the final stages of regulatory review in many countries. Tadalafil is the first such agent to gain preliminary EU approval and is reviewed in detail in this report. Focusing on its phase II/III trial results, tadalafil appears to have an enhanced period of responsiveness extending out to 36 hours in 60% of men using the 20 mg dose. Efficacy across a large population of men with ED of various causes (n = 1112) is in accordance with the other PDE5 inhibitors at 81%. Side effects are generally mild-to-moderate with study drop-out rate at 1.7% in the active arm compared to 1.1% among those receiving placebo. In summary, this agent will likely play an important role in the management of ED across a broad spectrum of aetiologies, once past the ongoing regulatory review process.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".