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Tdl3.0
Tadalafil – Forschung
Überwiegend Mechanismus / Beobachtung
23 begutachtete Studien
Was die Evidenz sagt
Überwiegend Mechanismus / Beobachtung
Die meisten Studien zu Tadalafil sind mechanistisch oder beobachtend statt RCTs, die einen klinischen Effekt messen — betrachte die Ergebnisse als vorläufig.
Die meiste Evidenz stammt aus hochwertigen Meta-Analysen und randomisierten Studien, veröffentlicht 2007–2026 mit einer typischen Studiengröße von 483 Teilnehmenden.
Basierend auf 23 Studien · 6 Meta-Analysen · 7 RCTs · 17,471 Teilnehmende insgesamt
Konfidenz
Hohe Konfidenz
Nach Outcome
Cardiovascular & vascular
Überwiegend Mechanismus / Beobachtung8 Studien
Safety profile
Überwiegend Mechanismus / Beobachtung7 Studien
Mortality (associational)
Überwiegend Mechanismus / Beobachtung3 Studien
Dementia risk (associational)
Überwiegend Mechanismus / Beobachtung3 Studien
Aktives Forschungsgebiet
20 Studien in den letzten 5 Jahren · Neueste Meta-Analyse: 2026
200720162026
1Meta-Analysen=1,549 · large study2025
These findings support further investigation of PDE5 in chronic inflammatory conditions.
Cianciarulo C, Nguyen TH, Zacharias A, Standen N, Tucci J, Irving H. · International journal of molecular sciences (2025)
Long-term treatment was associated with reduced IL-6 (SMD = -0.64, p = 0.002) and P-selectin (SMD = -0.57, p = 0.02), and increased cGMP (SMD = 0.87, p = 0.0003).
Effects on IL-10 and nitric oxide were inconsistent across studies.
PDE5is are highly effective, with sildenafil showing a significantly greater efficacy compared with the other PDE5is.
Salonia A et al. · The journal of sexual medicine (2026)
Threshold analysis showed a statistically significant improvement in ED with sildenafil 100 mg [OR 2.20; 95% confidence interval (CI) 1.78-2.63] and 50 mg (OR 2.10; 95% CI 1.69-2.50) compared to placebo.
PDE5is are highly effective, with sildenafil showing a significantly greater efficacy compared with the other PDE5is.
The title is "Associations between PDE5is and vascular parameters: A systematic review and meta-analysis" ( https://www.crd.york.ac.uk/PROSPERO/ ) (Reg.
Zhang Y, Peng H, Xin S, Mao J, Zhang J, Li H, Luan Y, Liu X, Wang T, Liu J, Zhang H, Song W. · Systematic reviews (2025)
Mean differences (MDs) with 95% confidence intervals (CIs) were pooled.
However, the effects of PDE5is on the augmentation index, brachial artery diameter and reactive hyperemia index were not statistically significant.
Systematic review registration The present study protocol was reviewed and approved by PROSPERO.
Further high-quality RCTs with larger sample sizes are needed to confirm these findings.
Abdalaziz MAS, Hanafi YA, Hamed BM, Abbas OF, Khader KOM, Alzawahreh MK, Ghzayel H, Al Sharqi RY, Altawallbeh ZF. · Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica (2025)
The pooled analysis showed no significant difference in SET between tadalafil and silodosin (MD = 0.15, 95% CI [-0.28, 0.57], p=0.50), with significant heterogeneity.
Similarly, the pooled analysis showed no significant difference in SER between the two drugs (RR = 0.92, 95% CI [0.80 to 1.05], p=0.22), with heterogeneity.
However, after excluding one study, silodosin was favored over tadalafil for SER (RR 0.88, 95% CI [0.79 to 0.98], p=0.02).
However, it was associated with a higher incidence of adverse effects.
Hashmi TM, Zia R, Ashraf H, Siddiqui M, Haider A, Rumampouw V, Khan MA, Ahmed M, Iqbal J. · World journal of urology (2025)
However, combination therapy resulted in a higher incidence of pain (OR = 5.66, 95% CI 2.56 to 12.52; P < 0.01) and other adverse events (OR = 2.97, 95% CI 1.60 to 5.49; P < 0.01).
Conclusion Combination therapy with tamsulosin and tadalafil demonstrated superior efficacy over tamsulosin monotherapy in reducing LUTS, improving quality of life, and enhancing erectile function.
However, it was associated with a higher incidence of adverse effects.
The FDC 0.5/5 mg demonstrated superior efficacy, and an acceptable safety profile compared with dutasteride and tadalafil monotherapies in patients with BPH.
Lee SW et al. · BJU international (2026)
Although the maximum urinary flow rate and post-void residual volume improved in all groups, differences were not statistically significant.
In the comparison between the FDC 0.5/5 mg and dutasteride 0.5 mg groups, the LSMD (95% CI) of change from baseline to Week 48 in the international index of erectile function - erectile function (IIEF - EF) total score was 4.03 (2.35 to -5.71) (P < 0.05).
Among the 655 patients analysed for safety, treatment-emergent adverse events occurred in 32.88% (FDC 0.5/5 mg) vs 21.20% (dutasteride 0.5 mg) and 26.48% (tadalafil 5 mg), with few serious adverse events observed.
Yan L, Chen L, Tao M, Zhang X, He R, Man L. · Frontiers in neurology (2026)
A modest reduction in diastolic blood pressure was also observed (MD = -4.65 mmHg, 95% CI: -5.96 to -3.34, p < 0.00001).
The overall risk of adverse events was increased (RR = 2.36, 95% CI: 1.53-3.65, p = 0.0001), but no severe adverse events were reported.
Conclusion PDE5-Is significantly improve cerebral hemodynamic parameters in patients with CSVD, alongside a modest reduction in diastolic blood pressure.
Jiang X, Sun F, Shi P, Gu X, Zhao X, Zhang X, Xu Y, Gao X, Ma Y, Fu Y, Cao Y. · Clinical and translational science (2025)
The 90% confidence intervals of geometric mean ratios of primary PK parameters were all within the bioequivalence range of 80.00%-125.00%.
AEs were mild or moderate and no SAEs were reported.
Under fasting conditions, the test OSF formulation was bioequivalent to the reference tablets, and the test OSF administered with water was bioequivalent to that without water.
Registered 5th August 2024, https://clinicaltrials.gov/study/NCT06543628 .
Zhang Q, Lv B, Yu H, Fu Y, Xu R, Liao Z, Zhang X, Fu Y, Huang W, Huang X. · Trials (2025)
Additional assessments will include the Erection Hardness Score (EHS), penile blood flow parameters, and elasticity values for a comprehensive evaluation.
Discussion The study aims to evaluate the efficacy of tadalafil combined with LIPUS for treating ED and to improve the evaluation of treatment response in erectile dysfunction by integrating blood flow parameters and two-dimensional shear wave elastography.
13Systematische Übersichtn=1,865 · large study2025
In our study, solifenacin may be considered the most effective medication for SRD.
Moon YJ, Chung DY, Kim DK, Jung HD, Jeon SH, Kang SH, Paick S, Lee JY, Korean Society of Endourology and Robotics (KSER) Research Committee. · Medicina (Kaunas, Lithuania) (2025)
Compared with the placebo, mirabegron (mean difference (MD): -3.87; 95% confidence interval (CI): -10.6-2.35), tadalafil (MD: -4.47; 95% CI: -10.8-1.63), and silodosin (MD: -4.02; 95% CI: -12-4.01) did not show significant differences to the placebo, whereas others did.
In the random effect model, P-score tests showed that solifenacin possessed the highest P-score ( p = 0.8484); tamsulosin was the second highest ( p = 0.7054).
Conclusions : Compared with the placebo, solifenacin, tamsulosin, and alfuzosin significantly decreased the USS.
Ölmestig J, Mortensen KN, Thomas MB, Fagerlund B, Naveed N, Nordling MM, Nielsen MKK, Rasmussen BS, Christensen H, Iversen HK, Poulsen MB, Siebner HR, Kruuse C. · Stroke (2025)
A binary logistic regression model with the treatment group as a covariate was used to calculate the primary outcome of feasibility (≥90% study drug compliance).
Seventy-one initiated treatment, and 26 of 38 participants with tadalafil were ≥90% compliant versus 31 of 33 with placebo (odds ratio, 0.13 [95% CI, 0.03-0.69]; P =0.030).
There was a female preponderance in tadalafil dropouts, with 46% of females stopping treatment, compared with only 16% of males.
Conclusion The combination of levocarnitine and tadalafil shows significant efficacy and safety in treating oligozoospermia and asthenozoospermia, effectively enhancing serum testosterone levels, sexual function, and semen quality.
Zhou X, Yao Z, Zheng J. · Hormones (Athens, Greece) (2025)
Results Post-treatment, both groups showed significant increases in serum T levels, all domains of IIEF scores (erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction), semen volume, sperm concentration, sperm viability, and PR (p < 0.001).
Group A demonstrated significantly better results than Group B in all these parameters (p < 0.05).
Differences in LH and FSH levels between the groups after treatment were not statistically significant (p > 0.05).
Further research is warranted to validate these results and explore long-term efficacy and safety.
Zeinelabden KM, Elsayed EA, Aziz M, Mamdoh H. · Minerva urology and nephrology (2025)
Urodynamic improvements were also notable in the combination therapy groups, with significant increases in bladder capacity and compliance, and reduction in detrusor contractions compared to placebo.
With the exception of high post voiding residual was high with solifenacin monotherapy Adverse effects were similar across groups, with no significant differences in overall incidence.
These findings suggest that combination therapy is alternative pathway which can enhance outcomes for female patients with OAB.
This trial was registered at www.clinicaltrials.gov as #NCT05142254.
Idris IM, Yusuf AA, Ismail II, Borodo AM, Hikima MS, Kana SA, Aliyu T, Musangedu K, Jibrilla AU, Aji SA, Kuliya-Gwarzo A, Mohammad K, Galadanci JA, Alkassim R, Suwaid MA, Hussaini N, Rodeghier M, Burnett AL, DeBaun MR. · Blood (2025)
The trial's primary outcome measures were 100% recruitment, 98.4% retention, and 93.5% adherence rates.
Over a median of 10 months (interquartile range, 3-12), 2.5 and 3.02 priapism events per participant-month were recorded in the usual-care and the experimental arms, with an incidence rate ratio of 0.8 (95% confidence interval [CI], 0.3-1.9; P = .654).
Sperm concentration, motility, and normal morphology significantly decreased on hydroxyurea therapy but recovered to prehydroxyurea levels 3 months after therapy cessation.