human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIM To evaluate patient preferences for sildenafil citrate or tadalafil ( PDE-5 inhibitors available for the treatment of erectile dysfunction [ ED ] ) and assess potential reasons for these preferences . METHODS This open-label study was conducted on Korean men taking sildenafil , at least 6 weeks prior to study entry , for ED . Following screening , patients continued sildenafil treatment for 4 weeks , then after a 1-week washout period , switched to tadalafil for 8 weeks . Patients then continued with their treatment of choice during an extension phase . Psychosocial factors ( time concern , spontaneity , sexual self-confidence ) were evaluated using Psychological and Interpersonal Relationship Scales ( PAIRS ) , while timing of dose to sexual attempt patterns were assessed from patient diaries . RESULTS The present study enrolled 160 Korean men ( mean age 55 years ) with prior median sildenafil use of 585 days . During the extension phase , 73.7 % of patients elected to take tadalafil , whereas 26.3 % chose sildenafil ( P < 0.001 ) . After switching from sildenafil to tadalafil , mean PAIRS time concern scores decreased from 2.54 to 2.42 ( P = 0.002 ) , with no statistically significant differences observed between the sildenafil and tadalafil assessment phases in sexual spontaneity and self-confidence scores . Sexual attempts made > 4 h to =/ < 36 h post-dose occurred in 4.5 % of patients during the sildenafil assessment phase compared with 17.5 % during the tadalafil assessment phase . CONCLUSION After experiencing both sildenafil and tadalafil , the majority of patients exhibited a preference for tadalafil . This preference might be influenced by psychosocial factors , such as decreased time concerns , and a broader window of opportunity available for sexual activity The study was to compare treatment preference , efficacy , and tolerability of sildenafil citrate ( sildenafil ) and tadalafil for treating erectile dysfunction ( ED ) in Chinese men naοve to phosphodiesterase 5 ( PDE5 ) inhibitor therapies .  This multicenter , r and omized , open-label , crossover study evaluated whether Chinese men with ED preferred 20-mg tadalafil or 100-mg sildenafil . After a 4 weeks baseline assessment , 383 eligible patients were r and omized to sequential 20-mg tadalafil per 100-mg sildenafil or vice versa for 8 weeks respectively and then chose which treatment they preferred to take during the 8 weeks extension . Primary efficacy was measured by Question 1 of the PDE5 Inhibitor Treatment Preference Question naire ( PITPQ ) . Secondary efficacy was analyzed by PITPQ Question 2 , the International Index of Erectile Function ( IIEF ) erectile function ( EF ) domain , sexual encounter profile ( SEP ) Questions 2 and 3 , and the Drug Attributes Question naire . Three hundred and fifty men ( 91 % ) completed the r and omized treatment phase . Two hundred and forty-two per 350 ( 69.1 % ) patients preferred 20-mg tadalafil , and 108/350 ( 30.9 % ) preferred 100-mg sildenafil ( P < 0.001 ) as their treatment in the 8 weeks extension . Ninety-two per 242 ( 38 % ) patients strongly preferred tadalafil and 37/108 ( 34.3 % ) strongly the preferred sildenafil . The SEP2 ( penetration ) , SEP3 ( successful intercourse ) , and IIEF-EF domain scores were improved in both tadalafil and sildenafil treatment groups . For patients who preferred tadalafil , getting an erection long after taking the medication was the most reported reason for tadalafil preference . The only treatment-emergent adverse event reported by > 2 % of men was headache . After tadalafil and sildenafil treatments , more Chinese men with ED naοve to PDE5 inhibitor preferred tadalafil . Both sildenafil and tadalafil treatments were effective and safe PURPOSE To assess  patient preference for erectile dysfunction  treatment between either sildenafil or tadalafil , each administered with their respective dosing instructions , and to evaluate preference for either sildenafil or tadalafil dosing instructions during tadalafil therapy . METHODS We conducted a r and omized , double-blind , crossover study consisting of four treatment arms . Because the dosing instructions for sildenafil and tadalafil are different , a unique methodology using sham placebo arms was employed to maintain the blind . To assess drug preference , 219 patients were r and omized to either sildenafil 50 mg or tadalafil 20 mg , with dosing instructions reflecting their respective product profiles . To assess dosing instruction preference during tadalafil therapy , 46 patients were r and omized to tadalafil 20 mg with either tadalafil or sildenafil dosing instructions . After 12 weeks , patients were crossed-over . After 4 weeks of each treatment , all patients following sildenafil dosing instructions were offered the opportunity for an upward dose titration . In a double-blind fashion , all patients who requested an upward titration received additional capsules . To mimic the pattern of dose usage observed in clinical practice , the number of patients who received additional double-blind active medication was limited to 35 % of patients taking sildenafil  in each treatment period in each country . Following the crossover treatment period , patients chose their preferred double-blind treatment with dosing instructions to receive in the 12-week extension period . RESULTS In the drug preference assessment , 132 of 181 ( 73 % ) evaluable patients chose to receive tadalafil ( p < 0.001 ) during the extension period . In the dosing instruction preference assessment , 24 of 36 ( 67 % ) evaluable patients preferred tadalafil with tadalafil dosing instructions ( p = 0.046 ) . Sildenafil and tadalafil were well tolerated . CONCLUSIONS In the doses utilized in this study , 73 % of patients preferred tadalafil with tadalafil dosing instructions for the treatment of their erectile dysfunction over sildenafil with sildenafil dosing instructions . During tadalafil therapy , 67 % of patients preferred tadalafil dosing instructions over sildenafil dosing instructions Sildenafil and tadalafil are efficacious and well tolerated in Chinese men with erectile dysfunction ( ED ) . Recent study results indicate that men with ED in China who were naïve to phosphodiesterase inhibitor type 5 ( PDE5 ) therapy prefer tadalafil 20-mg ( on-dem and ) versus sildenafil 100-mg ( on-dem and ) . Differences in psychosocial outcomes may help to explain treatment preference in favor of tadalafil . This open-label , r and omized , crossover study compared psychosocial outcomes and drug attribute choices between tadalafil and sildenafil in Chinese men with ED naïve to PDE5 inhibitor therapy . Eligible patients were r and omized to sequential 20-mg tadalafil/100-mg sildenafil ( n = 190 ) or 100-mg sildenafil/20-mg tadalafil ( n = 193 ) for 8 weeks each and were asked which treatment they preferred to take for the 8-week extension phase . Psychosocial outcomes were assessed using the Psychological and Interpersonal Relationship Scale ( PAIRS ) , Drug Attributes Question naire ( DRAQ ) , and Sexual Life Quality Question naire ( SLQQ ) . When taking tadalafil versus sildenafil , men had a higher mean endpoint score on the PAIRS Spontaneity Domain  ( tadalafil = 2.86 vs sildenafil = 2.72 ; P < 0.001 ) , and a lower mean endpoint score on the Time Concerns Domain ( tadalafil = 2.41 vs sildenafil = 2.55 ; P < 0.001 ) . A numerical increase in the Sexual Self-Confidence Domain was observed when taking tadalafil versus sildenafil ( tadalafil = 2.76 vs sildenafil = 2.72 ; P = 0.102 ) . The most frequently chosen drug attributes explaining treatment preference were able to get an erection long after having drug , and ability to get an erection every time . SLQQ results were comparable between treatment groups . These psychosocial outcomes may explain why more Chinese men preferred tadalafil versus sildenafil for the treatment of ED in this clinical trial Objectives : To assess the efficacy of tadalafil de-escalation in the therapeutic effects of psychogenic erectile dysfunction ( ED ) during the 3 months extension phase . Methods : A total of 90 men with mild to severe psychogenic ED were r and omly divided into 2 groups : tadalafil 5 mg group and tadalafil de-escalation group . Efficacy assessment s included the 5-item version of International Index of Erectile Function ( IIEF-5 ) , the Sexual Encounter Profile ( SEP ) question naires , Psychological and Interpersonal Relationship Scales ( PAIRS ) , Erection Hardness Score ( EHS ) . Results : Compared with the baseline , tadalafil 5 mg and de-escalation groups enhanced all efficacy outcomes . Patients receiving tadalafil 5 mg and de-escalation experienced a significant mean improvement in the psychogenic erectile function domain of the IIEF-5 from the baseline ( p < 0.01 ) . The mean change from baseline was significantly higher for the tadalafil de-escalation group than for the tadalafil 5 mg group ( p < 0.05 ) . Response to SEP3 , PAIRS and EHS was significantly higher in the tadalafil de-escalation group than in the tadalafil 5 mg group ( p < 0.05 ) . The severity of ED in the tadalafil de-escalation group had reduced after treatment . It was also significantly better than those in the tadalafil 5 mg group ( p < 0.05 ) . Conclusion : Tadalafil de-escalation significantly improved the erectile function among psychogenic ED patients . This implies that tadalafil de-escalation treatment for psychogenic ED is worthy of further clinical practice and research The impact of erectile dysfunction is distressing to both males and their female partners , but less attention has been paid to identify female partners′ preferred treatment and sexual quality of life outcomes . The present analysis explores female partners′ treatment preference for erectile dysfunction in Chinese Men . This was a phase 4 , r and omized , open-label , multicenter , crossover study in Chinese men with erectile dysfunction who were naïve to phosphodiesterase type 5 inhibitor treatments . Eligible patients were r and omized to sequential 20-mg tadalafil/100-mg sildenafil or 100-mg sildenafil/20-mg tadalafil for 8 weeks each . Of 418 patients , female partners of 64 patients agreed to enter the study ; of 64 patients who entered the study with female partners , 63 were r and omized , and 62 completed the study . Baseline demographics and disease characteristics were comparable between treatment groups . Significantly more couples preferred tadalafil compared with sildenafil overall ( 75.4 % vs 24.6 % ; P < 0.001 ) , and irrespective of erectile dysfunction severity at baseline ( P ≤ 0.005 ) . Significant improvements in sexual quality of life scores were reported at endpoint ( Visit 8) in male patients and female partners in both tadalafil and sildenafil treatment groups ( P < 0.001 ) . Significantly higher mean changes from baseline were observed for male patients in the tadalafil group compared with the sildenafil group for the erectile function ( P = 0.013 ) and overall satisfaction ( P = 0.019 ) International Index for Erectile Function domains and the spontaneity domain ( P < 0.001 ) of the Psychological and Interpersonal Relationship Scale . No major safety concerns were reported during the study . Though both treatments were effective , safe , and tolerable , more couples preferred tadalafil compared with sildenafil Introduction Erectile dysfunction ( ED ) is currently one of the most common sexual dysfunctions worldwide but it is usually underestimated because it is not a life threatening condition . The associated stigma makes men who have it to suffer in silence . This study was conducted to determine the prevalence of erectile dysfunction and the possible associated risk factors among Nigerian men . Methods The study was a descriptive cross-sectional population based survey  among men aged 30 - 80 years in Ogbomoso , South-west , Nigeria . A multistage r and om sampling method was used . The instrument used was the  International Index of Erectile Function Question naire-5 ( IIEF-5 ) . Unadjusted odds ratios of possible risk factors were calculated by univariate analyses . Binary logistic regression analysis was used to eliminate the effect of possible confounders on the risk factors to get the adjusted odds ratios . Results The general prevalence of ED in this study was 58.9 % . Sixty-seven ( 47.2 % ) , 16 ( 11.3 % ) and 59(41.5 % ) respondents had mild , moderate and severe ED respectively . Age , hypertension , use of anti-hypertensive drugs , diabetes mellitus and heart disease all had significant unadjusted associations with ED , but their adjusted associations were not statistically significant . Diabetes mellitus maintained a positive statistically significant relationship with ED after adjustment for potential 
    Output:
    
agent
In the meta- analysis , tadalafil and sildenafil appeared to have similar efficacies and overall adverse event rates .
However , compared with sildenafil , tadalafil significantly improved psychological outcomes .
Furthermore , the patients and their partners preferred tadalafil over sildenafil , and no significant difference was found in the adherence and persistence rates between tadalafil and sildenafil .
Additionally , the myalgia and back pain rates were higher and the flushing rate was lower with tadalafil than with sildenafil .
Conclusion Tadalafil shares a similar efficacy and safety with sildenafil and significantly improves patients ’ sexual confidence .
Furthermore , patients and their partners prefer tadalafil to sildenafil .
Hence , tadalafil may be a better choice for ED treatment
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIM To evaluate patient preferences for sildenafil citrate or tadalafil ( PDE-5 inhibitors available for the treatment of erectile dysfunction [ ED ] ) and assess potential reasons for these preferences . METHODS This open-label study was conducted on Korean men taking sildenafil , at least 6 weeks prior to study entry , for ED . Following screening , patients continued sildenafil treatment for 4 weeks , then after a 1-week washout period , switched to tadalafil for 8 weeks . Patients then continued with their treatment of choice during an extension phase . Psychosocial factors ( time concern , spontaneity , sexual self-confidence ) were evaluated using Psychological and Interpersonal Relationship Scales ( PAIRS ) , while timing of dose to sexual attempt patterns were assessed from patient diaries . RESULTS The present study enrolled 160 Korean men ( mean age 55 years ) with prior median sildenafil use of 585 days . During the extension phase , 73.7 % of patients elected to take tadalafil , whereas 26.3 % chose sildenafil ( P < 0.001 ) . After switching from sildenafil to tadalafil , mean PAIRS time concern scores decreased from 2.54 to 2.42 ( P = 0.002 ) , with no statistically significant differences observed between the sildenafil and tadalafil assessment phases in sexual spontaneity and self-confidence scores . Sexual attempts made > 4 h to =/ < 36 h post-dose occurred in 4.5 % of patients during the sildenafil assessment phase compared with 17.5 % during the tadalafil assessment phase . CONCLUSION After experiencing both sildenafil and tadalafil , the majority of patients exhibited a preference for tadalafil . This preference might be influenced by psychosocial factors , such as decreased time concerns , and a broader window of opportunity available for sexual activity The study was to compare treatment preference , efficacy , and tolerability of sildenafil citrate ( sildenafil ) and tadalafil for treating erectile dysfunction ( ED ) in Chinese men naοve to phosphodiesterase 5 ( PDE5 ) inhibitor therapies .  This multicenter , r and omized , open-label , crossover study evaluated whether Chinese men with ED preferred 20-mg tadalafil or 100-mg sildenafil . After a 4 weeks baseline assessment , 383 eligible patients were r and omized to sequential 20-mg tadalafil per 100-mg sildenafil or vice versa for 8 weeks respectively and then chose which treatment they preferred to take during the 8 weeks extension . Primary efficacy was measured by Question 1 of the PDE5 Inhibitor Treatment Preference Question naire ( PITPQ ) . Secondary efficacy was analyzed by PITPQ Question 2 , the International Index of Erectile Function ( IIEF ) erectile function ( EF ) domain , sexual encounter profile ( SEP ) Questions 2 and 3 , and the Drug Attributes Question naire . Three hundred and fifty men ( 91 % ) completed the r and omized treatment phase . Two hundred and forty-two per 350 ( 69.1 % ) patients preferred 20-mg tadalafil , and 108/350 ( 30.9 % ) preferred 100-mg sildenafil ( P < 0.001 ) as their treatment in the 8 weeks extension . Ninety-two per 242 ( 38 % ) patients strongly preferred tadalafil and 37/108 ( 34.3 % ) strongly the preferred sildenafil . The SEP2 ( penetration ) , SEP3 ( successful intercourse ) , and IIEF-EF domain scores were improved in both tadalafil and sildenafil treatment groups . For patients who preferred tadalafil , getting an erection long after taking the medication was the most reported reason for tadalafil preference . The only treatment-emergent adverse event reported by > 2 % of men was headache . After tadalafil and sildenafil treatments , more Chinese men with ED naοve to PDE5 inhibitor preferred tadalafil . Both sildenafil and tadalafil treatments were effective and safe PURPOSE To assess  patient preference for erectile dysfunction  treatment between either sildenafil or tadalafil , each administered with their respective dosing instructions , and to evaluate preference for either sildenafil or tadalafil dosing instructions during tadalafil therapy . METHODS We conducted a r and omized , double-blind , crossover study consisting of four treatment arms . Because the dosing instructions for sildenafil and tadalafil are different , a unique methodology using sham placebo arms was employed to maintain the blind . To assess drug preference , 219 patients were r and omized to either sildenafil 50 mg or tadalafil 20 mg , with dosing instructions reflecting their respective product profiles . To assess dosing instruction preference during tadalafil therapy , 46 patients were r and omized to tadalafil 20 mg with either tadalafil or sildenafil dosing instructions . After 12 weeks , patients were crossed-over . After 4 weeks of each treatment , all patients following sildenafil dosing instructions were offered the opportunity for an upward dose titration . In a double-blind fashion , all patients who requested an upward titration received additional capsules . To mimic the pattern of dose usage observed in clinical practice , the number of patients who received additional double-blind active medication was limited to 35 % of patients taking sildenafil  in each treatment period in each country . Following the crossover treatment period , patients chose their preferred double-blind treatment with dosing instructions to receive in the 12-week extension period . RESULTS In the drug preference assessment , 132 of 181 ( 73 % ) evaluable patients chose to receive tadalafil ( p < 0.001 ) during the extension period . In the dosing instruction preference assessment , 24 of 36 ( 67 % ) evaluable patients preferred tadalafil with tadalafil dosing instructions ( p = 0.046 ) . Sildenafil and tadalafil were well tolerated . CONCLUSIONS In the doses utilized in this study , 73 % of patients preferred tadalafil with tadalafil dosing instructions for the treatment of their erectile dysfunction over sildenafil with sildenafil dosing instructions . During tadalafil therapy , 67 % of patients preferred tadalafil dosing instructions over sildenafil dosing instructions Sildenafil and tadalafil are efficacious and well tolerated in Chinese men with erectile dysfunction ( ED ) . Recent study results indicate that men with ED in China who were naïve to phosphodiesterase inhibitor type 5 ( PDE5 ) therapy prefer tadalafil 20-mg ( on-dem and ) versus sildenafil 100-mg ( on-dem and ) . Differences in psychosocial outcomes may help to explain treatment preference in favor of tadalafil . This open-label , r and omized , crossover study compared psychosocial outcomes and drug attribute choices between tadalafil and sildenafil in Chinese men with ED naïve to PDE5 inhibitor therapy . Eligible patients were r and omized to sequential 20-mg tadalafil/100-mg sildenafil ( n = 190 ) or 100-mg sildenafil/20-mg tadalafil ( n = 193 ) for 8 weeks each and were asked which treatment they preferred to take for the 8-week extension phase . Psychosocial outcomes were assessed using the Psychological and Interpersonal Relationship Scale ( PAIRS ) , Drug Attributes Question naire ( DRAQ ) , and Sexual Life Quality Question naire ( SLQQ ) . When taking tadalafil versus sildenafil , men had a higher mean endpoint score on the PAIRS Spontaneity Domain  ( tadalafil = 2.86 vs sildenafil = 2.72 ; P < 0.001 ) , and a lower mean endpoint score on the Time Concerns Domain ( tadalafil = 2.41 vs sildenafil = 2.55 ; P < 0.001 ) . A numerical increase in the Sexual Self-Confidence Domain was observed when taking tadalafil versus sildenafil ( tadalafil = 2.76 vs sildenafil = 2.72 ; P = 0.102 ) . The most frequently chosen drug attributes explaining treatment preference were able to get an erection long after having drug , and ability to get an erection every time . SLQQ results were comparable between treatment groups . These psychosocial outcomes may explain why more Chinese men preferred tadalafil versus sildenafil for the treatment of ED in this clinical trial Objectives : To assess the efficacy of tadalafil de-escalation in the therapeutic effects of psychogenic erectile dysfunction ( ED ) during the 3 months extension phase . Methods : A total of 90 men with mild to severe psychogenic ED were r and omly divided into 2 groups : tadalafil 5 mg group and tadalafil de-escalation group . Efficacy assessment s included the 5-item version of International Index of Erectile Function ( IIEF-5 ) , the Sexual Encounter Profile ( SEP ) question naires , Psychological and Interpersonal Relationship Scales ( PAIRS ) , Erection Hardness Score ( EHS ) . Results : Compared with the baseline , tadalafil 5 mg and de-escalation groups enhanced all efficacy outcomes . Patients receiving tadalafil 5 mg and de-escalation experienced a significant mean improvement in the psychogenic erectile function domain of the IIEF-5 from the baseline ( p < 0.01 ) . The mean change from baseline was significantly higher for the tadalafil de-escalation group than for the tadalafil 5 mg group ( p < 0.05 ) . Response to SEP3 , PAIRS and EHS was significantly higher in the tadalafil de-escalation group than in the tadalafil 5 mg group ( p < 0.05 ) . The severity of ED in the tadalafil de-escalation group had reduced after treatment . It was also significantly better than those in the tadalafil 5 mg group ( p < 0.05 ) . Conclusion : Tadalafil de-escalation significantly improved the erectile function among psychogenic ED patients . This implies that tadalafil de-escalation treatment for psychogenic ED is worthy of further clinical practice and research The impact of erectile dysfunction is distressing to both males and their female partners , but less attention has been paid to identify female partners′ preferred treatment and sexual quality of life outcomes . The present analysis explores female partners′ treatment preference for erectile dysfunction in Chinese Men . This was a phase 4 , r and omized , open-label , multicenter , crossover study in Chinese men with erectile dysfunction who were naïve to phosphodiesterase type 5 inhibitor treatments . Eligible patients were r and omized to sequential 20-mg tadalafil/100-mg sildenafil or 100-mg sildenafil/20-mg tadalafil for 8 weeks each . Of 418 patients , female partners of 64 patients agreed to enter the study ; of 64 patients who entered the study with female partners , 63 were r and omized , and 62 completed the study . Baseline demographics and disease characteristics were comparable between treatment groups . Significantly more couples preferred tadalafil compared with sildenafil overall ( 75.4 % vs 24.6 % ; P < 0.001 ) , and irrespective of erectile dysfunction severity at baseline ( P ≤ 0.005 ) . Significant improvements in sexual quality of life scores were reported at endpoint ( Visit 8) in male patients and female partners in both tadalafil and sildenafil treatment groups ( P < 0.001 ) . Significantly higher mean changes from baseline were observed for male patients in the tadalafil group compared with the sildenafil group for the erectile function ( P = 0.013 ) and overall satisfaction ( P = 0.019 ) International Index for Erectile Function domains and the spontaneity domain ( P < 0.001 ) of the Psychological and Interpersonal Relationship Scale . No major safety concerns were reported during the study . Though both treatments were effective , safe , and tolerable , more couples preferred tadalafil compared with sildenafil Introduction Erectile dysfunction ( ED ) is currently one of the most common sexual dysfunctions worldwide but it is usually underestimated because it is not a life threatening condition . The associated stigma makes men who have it to suffer in silence . This study was conducted to determine the prevalence of erectile dysfunction and the possible associated risk factors among Nigerian men . Methods The study was a descriptive cross-sectional population based survey  among men aged 30 - 80 years in Ogbomoso , South-west , Nigeria . A multistage r and om sampling method was used . The instrument used was the  International Index of Erectile Function Question naire-5 ( IIEF-5 ) . Unadjusted odds ratios of possible risk factors were calculated by univariate analyses . Binary logistic regression analysis was used to eliminate the effect of possible confounders on the risk factors to get the adjusted odds ratios . Results The general prevalence of ED in this study was 58.9 % . Sixty-seven ( 47.2 % ) , 16 ( 11.3 % ) and 59(41.5 % ) respondents had mild , moderate and severe ED respectively . Age , hypertension , use of anti-hypertensive drugs , diabetes mellitus and heart disease all had significant unadjusted associations with ED , but their adjusted associations were not statistically significant . Diabetes mellitus maintained a positive statistically significant relationship with ED after adjustment for potential 
    Output:
    