Affiliation:
1. Department of Urology University of California San Francisco San Francisco California USA
2. Department of Urology MedStar Georgetown University Hospital Washington District of Columbia USA
3. Department of Plastic and Reconstructive Surgery MedStar Georgetown University Hospital Washington District of Columbia USA
4. Department of Epidemiology and Biostatistics University of California San Francisco San Francisco California USA
Abstract
AbstractPurposeTo explore the differences of priapism events among a diverse cohort taking erectogenic medicines (i.e., phosphodiesterase type 5 inhibitors [PDE5i] and intracavernousal drugs).MethodsWe queried the World Health Organization global database of individual case safety reports (VigiBase) for records of the adverse drug reactions (ADR) with sildenafil, tadalafil, avanafil, vardenafil, papaverine, and alprostadil. Disproportionality analyses (case/non‐case approach) were performed to assess the reporting odds ratio (ROR) of priapism reporting in PDE5i consumers compared to intracavernousal drug recipients.ResultsFrom a total of 133 819 ADR events for erectogenic medications, 632 were priapism (PDE5is: n = 550, 0.41%; intracavernousal drugs: n = 82, 9.92%). Priapism disproportionality signals from intracavernousal drugs were 25 times stronger than PDE5is (ROR = 34.7; confidence interval [CI] 95%: 27.12–43.94 vs. ROR = 1.38; 95% CI: 1.24–1.54). For all PDE5i agents, the 12–17 years age group had the highest ROR (9.49, 95% CI: 3.76–19.93) followed by 2–11 years (4.31, 95% CI: 1.57–9.4). Disproportionality signals for consumers under 18 for both all PDE5is as a whole (ROR = 4.57, 95% CI: 2.48–7.73) and sildenafil (ROR = 4.89, 95% CI: 2.51–8.62) were stronger than individuals 18 or older (ROR = 1.06, 95% CI: 0.93–1.21 and ROR = 1.08, 95% CI: 0.91–1.26, respectively).ConclusionsPDE5i use shows disproportionate priapism signals which are higher in young patients.
Subject
Pharmacology (medical),Epidemiology