PDE5is do not induce ocular adverse events

Use of phosphodiesterase 5 inhibitor (PDE5i) for erectile dysfunction (ED) or benign prostatic hyperplasia (BPD) does not seem to heighten the risk of ocular events in men, reveals a study.

Analysis for this study made use of the IBM MarketScan (2007‒2021) Commercial and Medicare Supplemental Databases (version (2.0).

In estimating the overall events risk, the authors used Cox proportional hazard models to calculate the hazard ratios (HRs) for ED diagnosis, and the different treatments, adjusting for region, median age, obesity, diabetes, hyperlipidemia, smoking, hypertension, coronary artery disease, and sleep apnoea. HRs for BPH diagnosis and different treatments were also calculated using the same analyses.

A total of 1,938,262 men had an ED diagnosis, of whom 615,838 (31.8 percent) were treated with PDE5i. On the other hand, 2,175,439 men had a BPH diagnosis, of whom 175,725 (8.1 percent) received PDE5i.

Adjusted Cox regression analysis revealed that use of PDE5i did not correlate with serous retinal detachment (SRD), retinal vascular occlusion (RVO), ischaemic optic neuropathy (ION), and any ocular event when compared with ED diagnosis and other ED treatments. Notably, the risk of ocular events rose as the intensity of ED treatment increased.

Likewise, PDE5i use showed no association with SRD and ION when compared with BPH diagnosis and other BPH treatments. However, PDE5i use correlated with RVO (hazard ratio [HR], 1.14, 95 percent confidence interval [CI], 1.06‒1.23) in patients with BPH. Notably, those treated with other agents (ie, 5a reductase/alpha blocker; HR, 1.11, 95 percent CI, 1.06‒1.16) or surgery (HR, 1.10, 95 percent CI, 1.02‒1.19) had a higher RVO risk.

“Patients using PDE5is for ED or BPH indications did not have an increased risk of ocular events, even when compared with other treatments for ED or BPH,” the authors said.