Statin Use in Men and New Onset of Erectile Dysfunction: a Systematic Review and Meta-Analysis

Background Erectile dysfunction has been reported as an adverse effect of statin therapy. Methods We performed a meta-analysis of randomized trials and observational studies that compared statin users versus non-statin users and reported data regarding new onset of erectile dysfunction in men with established cardiovascular disease or cardiovascular disease risk factors. We used DerSimonian-Laird and Peto models to construct the summary estimates risk ratio (RR). We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment to assess the overall quality of evidence for new onset erectile dysfunction. Results Three randomized trials and 3 observational studies were identified with 69,448 men, of which, 24,661 were statin users. Five studies were considered high quality. Statin use was not associated with an increased risk of new onset of erectile dysfunction by random effects model or fixed effect model (RR: 0.96, 95% CI: 0.84 - 1.10, P = 0.58), and (OR: 0.95, 95% CI: 0.88 - 1.02, P = 0.20) respectively. This effect was similar in randomized trials and observational (Pinteraction = 0.86). Randomized trials provided a moderate quality of evidence, and observational studies provided a very low quality of evidence by the GRADE assessment. Random effects meta-regression analyses revealed no difference in treatment effect based on age or diabetes mellitus, P = 0.83 and P = 0.74 respectively. Conclusions Among men with established cardiovascular disease or cardiovascular disease risk factors, statin use does not appear to be associated with a new onset of erectile dysfunction. Adequately powered and high quality randomized trials are recommended to confirm these findings.

The American journal of medicine. 2017 Nov 13 [Epub ahead of print]

Akram Y Elgendy, Islam Y Elgendy, Ahmed N Mahmoud, Mohammad Al-Ani, Mohamed M Moussa, Ahmad Mahmoud, Mohammad K Mojadidi, R David Anderson

Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA., Department of Medicine, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA., Department of Medicine, University of Florida, Gainesville, FL, USA., Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA. Electronic address: .

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