Abstract
Context Erectile dysfunction is common in men with diabetes. Objective To assess the efficacy and safety of oral sildenafil citrate in the treatment of erectile dysfunction in men with diabetes. Design A multicenter, randomized, double-blind, placebo-controlled, flexible dose-escalation study conducted May through November 1996. Setting Patients' homes and 19 clinical practice centers in the United States. Patients A total of 268 men (mean age, 57 years) with erectile dysfunction (mean duration, 5.6 years) and diabetes (mean duration, 12 years). Interventions Patients were randomized to receive sildenafil (n = 136) or placebo (n = 132) as needed, but not more than once daily, for 12 weeks. Patients took the study drug or placebo 1 hour before anticipated sexual activity. The starting dose of sildenafil citrate was 50 mg, with the option to adjust the dose to 100 mg or 25 mg based on efficacy and tolerability, to be taken as needed. Main Outcome Measures Self-reported ability to achieve and maintain an erection for sexual intercourse according to the International Index of Erectile Function and adverse events. Results Two hundred fifty-two patients (94%) completed the study (131/136 in the sildenafil group, 121/132 in the placebo group). By intention-to-treat analysis, at 12 weeks, 74 (56%) of 131 patients in the sildenafil group reported improved erections compared with 13 (10%) of 127 patients in the placebo group (P