Erectile function in men with type 2 diabetes treated with dulaglutide: an exploratory analysis of the REWIND placebo controlled randomised trial.
Diabetes is a major risk factor for erectile dysfunction, however, there is less knowledge on the effect of GLP-1 receptor agonists on erectile dysfunction. Harpreet S Bajaj and colleagues published research in The Lancet Diabetes and Endocrinology under the title “Erectile function in men with type 2 diabetes treated with dulaglutide: an exploratory analysis of the REWIND placebo-controlled randomized trial”. The summary of this research is given below:
Objective:
To evaluate the incidence, prevalence, and progression of erectile dysfunction in men treated with dulaglutide
To investigate whether dulaglutide’s effect on erectile dysfunction was constant along with its effect on other diabetes-related outcomes.
Method:
The Researching Cardiovascular Events with a Weekly Incretin in Diabetes (REWIND) trial was conducted at 371 sites in 24 countries. Dulaglutide or placebo was randomly assigned to men and women aged older than 50 years who had a previous cardiovascular event or cardiovascular risk factors with type 2 diabetes. International Index of Erectile Function (IIEF) questionnaire was completed by participating men at baseline, 2 years, 5 years, and study end. Exploratory analysis was conducted that included participants who completed a baseline and at least 1 follow-up IIEF questionnaire. The main outcome of these analyses was to track the first occurrence of moderate or severe erectile dysfunction after randomization. This was assessed by the erectile function subscores on IIEF.
Findings:
The study found a lower incidence of moderate or severe erectile dysfunction in subjects who received dulaglutide as compared to the placebo group. While there is a lower hazard of incident or worsening erectile dysfunction, investigators didn’t find this drug potent enough to cause improvement in erectile dysfunction. This was evident by declining erectile function subscore with time in both the dulaglutide and placebo groups, while to a lesser extent with dulaglutide.
Limitation:
The study has certain limitation such as the restricted statistical power in subgroups, the fact that the first follow-up International Index of Erectile Function (IIEF) was not administered until the 2-year visit, the absence of hormonal concentration values, and the limited data regarding possible psychogenic, organic, or mixed causes of erectile dysfunction. Additionally, the non-participation of 30% of male subjects in the analyses who had a higher prevalence of several erectile dysfunction risk factors as compared to the included participants limit generalisability to individuals similar to those who were analyzed. It is unknown whether similar effects would be observed in younger individuals or those with a lower cardiovascular risk.
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