Nebivolol lowers risk of ED occurrence, progression

The use of nebivolol, compared with metoprolol, results in a significant reduction in the risk of erectile dysfunction (ED) occurrence or progression, regardless of whether the patient had ED or not, a recent study has shown.

A team of investigators searched for published randomized controlled trials (RCTs) in the databases of PubMed, Cochrane Library, Web of Science, and Embase until October 2023. They performed a statistical analysis using the Review Manager version 5.3.0 and sensitivity analyses using State 17 software. The International Index of Erectile Function (IIEF)-5 score was the primary outcome.

Four RCTs were included in the meta-analysis, all of which compared the effects of nebivolol on erectile function with metoprolol. Eight parallel groups with 397 participants reported IIEF-5 scores. In a random-effect model, the nebivolol group showed a significantly higher IIEF-5 score (mean difference, 1.81, 95 percent confidence interval, 0.95–2.68; p<0.0001; I2, 99 percent).

Results did not significantly differ in sensitivity analysis that removed each individual study. A prespecified subgroup analysis based on metoprolol dose, patients with ED at the time of enrolment, and disease type was also conducted. Subgroup analysis revealed a significantly decreased heterogeneity, as well as a stable and consistent result of the IIEF-5 score.

"Our results provide stronger evidence that nebivolol significantly reduced the risk of ED occurrence or progression,” said the investigators, noting that this meta-analysis could be a reference for future studies in this field.

This study was limited by its small number of RCTs and their heterogeneity.