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Prescribing Advice for GPs

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STI rates among users of ED drugs

The Annals of Internal Medicine has published the results of an analysis of a medical claims database of private, employer-based insurance in 44 large companies to assess the association between usage of medication to treat erectile dysfunction and sexually transmitted infections (STI).

The analysis identified claims made between 1997 and 2006 for 1,410,806 men older than age 40 years. Of these claimants, 33,968 obtained at least one prescription for a treatment for erectile dysfunction (ED) (sildenafil, tadalafil or vardenafil). The rate of STIs was assessed in the year before the first prescription and the year after and was compared to non-users of these treatments. The analysis particularly looked for reported infection with HIV, chlamydia, gonorrhoea, herpes or syphilis.

The analysis found significantly more infection cases in the year before a first prescription (214 versus 106 annually per 100,000 persons; P=0.003) and the year after (105 versus 65; P=0.004) among ED treatment users. The odds ratios from these figures are 2.80 (95% CI, 2.10 to 3.75) and 2.65 (CI, 1.84 to 3.81) respectively.

The authors note that selection bias in this study will preclude a conclusion about a causal relationship. They also note the higher rate of STIs in the year prior and conclude that the STI infection rates, "may have more to do with the types of patients using ED drugs rather than a direct effect of ED drug ".

Action: Clinicians should be aware of this study. Patient who request treatment for erectile dysfunction should be given information about safe sexual practices.

Thanks to PharmaGossip

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