BRAMPTON, ON — Even though diabetes is a major risk factor for erectile dysfunction, the effect of GLP-1 receptor agonists on erectile dysfunction remains unclear.
An international study led by Canadian researchers sought to assess the incidence, prevalence and progression of erectile dysfunction in men treated with dulaglutide compared with placebo. The report, published in The Lancet Diabetes & Endocrinology and including participation from the Ralph H Johnson VAMC in Charleston, SC, notes that the study team also set out to determine whether dulaglutide’s effect on erectile dysfunction was consistent with its effect on other diabetes-related outcomes.1
Data were from The Researching Cardiovascular Events with a Weekly Incretin in Diabetes (REWIND) study, a double-blind, placebo-controlled randomized trial of the effect of dulaglutide on cardiovascular outcomes. REWIND involved 371 sites in 24 countries.
Participants included men and women aged older than 50 years with Type 2 diabetes who had either a previous cardiovascular event or cardiovascular risk factors; the patients were randomly assigned (1:1) to receive either dulaglutide or placebo.
In addition, male participants were offered the opportunity to complete the standardized International Index of Erectile Function (IIEF) questionnaire at baseline, 2 years, 5 years and study end.
For this review, the authors did an exploratory analysis including participants who completed a baseline and at least one follow-up IIEF questionnaire. Defined as the primary outcome for the analyses was the first occurrence of moderate or severe erectile dysfunction following randomization, assessed by the erectile function subscores on IIEF.
Results indicate that, between Aug. 18, 2011, and Aug. 14, 2013, 70.1% of 5,312 male participants with a mean age of 65.5 were analyzed. The study team determined that 39.9% of them had a history of cardiovascular disease, and 56.5% had moderate or severe erectile dysfunction at baseline.
The study adds that the incidence of erectile dysfunction following randomization was 21.3 per 100 person-years in the dulaglutide group and 22.0 per 100 person-years in the placebo group (HR 0·92, 95% CI 0·85-0·99, p=0·021). The authors point out that men in the dulaglutide group also had a less steep fall in erectile function sub-score compared with the placebo group, with a least-square mean difference of 0·61 (95% CI 0·18-1·05, p=0·006).
“Long-term use of dulaglutide might reduce the incidence of moderate or severe erectile dysfunction in men with Type 2 diabetes,” the authors suggest.
- Bajaj HS, Gerstein HC, Rao-Melacini P, Basile J, et. Al. Erectile function in men with Type 2 diabetes treated with dulaglutide: an exploratory analysis of the REWIND placebo-controlled randomized trial. Lancet Diabetes Endocrinol. 2021 Jun 18:S2213-8587(21)00115-7. doi: 10.1016/S2213-8587(21)00115-7. Epub ahead of print. PMID: 34153269.