Using high sensitivity c-reactive protein to monitor response to tadalafil in patients with erectile dysfunction

This study aimed to evaluate if high-sensitivity C-reactive protein (hs-CRP) can be used to monitor the effectiveness of PD-5 inhibitors. This study found that lower hs-CRP before treatment is associated with better response to medication.  

Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It can be caused by several medical reasons. It is commonly found in aging men due to decreasing testosterone (the main male sex hormone) levels.

High-sensitivity C-reactive protein (hs-CRP) is a marker of inflammation. This is known to be elevated in patients with ED. Phosphodiesterase-5 inhibitors (PD-5) such as tadalafil (Cialis) are a type of medication to treat ED. It is unknown if hs-CRP can be used to monitor the effectiveness of PD-5 inhibitors.

This study included 282 men with ED. They were treated with tadalafil. Questionnaires were used to assess sexual satisfaction. They were divided into vasculogenic and non-vasculogenic ED groups. Vasculogenic means that there are problems with the blood vessels that cause the ED. This can be caused by diabetes or heart problems. 23.8% of the patients had vasculogenic ED. Hs-CRP was measured before treatment.

Vasculogenic ED patients had a poorer response to tadalafil. Those showing improvement with tadalafil had lower hs-CRP at baseline (on average 1.5 mg/L) compared to those with poorer response (average 2 mg/L). Also, patients with the highest response to treatment had the greatest reductions in hs-CRP levels. 

This study found that hs-CRP is elevated in patients with ED who are less likely to respond to tadalafil treatment.

There was a 22% dropout rate in this study. This might have influenced the results.