Silboesterol compared with placebo for stuttering priapism

Patient or population: men and boys with SCD and stuttering priapism

Settings: outpatients

Intervention: stilboestrol 5 mg

Comparison: placebo

Detumescence

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

Reduction in stuttering priapism

Follow‐up: 2 weeks

RR 2.92

(95% CI 0.73 to 11.70)

7
(1)

⊕⊝⊝⊝
very low^1,2

Immediate side effects of treatment

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

Effect on later sexual function

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

Other untoward side effects of treatment

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

Efficacy of a prevention strategy

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

*The basis for the assumed risk (e.g. the median control group risk across trials) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; N/A: not applicable; RR: risk ratio.

GRADE Working Group grades of evidence
High quality: further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: we are very uncertain about the estimate.

Sildenafil 50 mg compared with placebo for stuttering priapism

Patient or population: men and boys with SCD and stuttering priapism

Settings: outpatients

Intervention: sildenafil 50 mg daily

Comparison: placebo

Detumescence

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

Reduction in frequency of priapism

Follow‐up: 8 weeks

RR

0.58 (95% CI 0.07 to 4.95)

13

(1)

⊕⊕⊝⊝
low^1,2

There was also no significant difference between treatments for the reduction in episodes of priapism by score tier: RR 1.17 (95% CI 0.36 to 3.76).

Immediate side effects of treatment

Follow‐up: 16 weeks

N/A

13

(1)

⊕⊕⊝⊝
low^1,3

Side effects of treatment were reported for the whole treatment phase including the open label phase. No significant differences were found between sildenafil and placebo.

Effect on later sexual function

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

Other untoward side effects of treatment

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

Efficacy of a prevention strategy

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

*The basis for the assumed risk (e.g. the median control group risk across trials) is provided in footnotes. The corresponding risk (and its 95% CI is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; N/A: not applicable; RR: risk ratio.

GRADE Working Group grades of evidence
High quality: further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: we are very uncertain about the estimate.

Etilefrine 50 mg compared with placebo for stuttering priapism

Patient or population: men and boys with SCD and stuttering priapism

Settings: outpatient

Intervention: etilefrine 50mg once daily

Comparison: placebo

Detumescence

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

Reduction in frequency of priapism

Follow‐up: 6 months

N/A

23

(1)

⊕⊝⊝⊝
very low^1,2

No significant difference was found between etilefrine and placebo but there were concerns over the reliability of the published results.

Immediate side effects of treatment (palpitations)

Follow‐up: 6 months

RR

1.64 (95% CI 0.62 to 4.30)

23

(1)

⊕⊝⊝⊝
very low^1,2

No significant difference was seen between etilefrine and placebo for any of the other immediate side effects measured (lack of sleep, hand shaking, anxiety, dry mouth).

Immediate side effects of treatment (tachycardia)

Follow‐up: 6 months

RR 2.18 (95% CI 0.71 to 6.68)

23

(1)

⊕⊝⊝⊝
very low^1,2

No significant difference was seen between etilefrine and placebo for any of the other immediate side effects measured (lack of sleep, hand shaking, anxiety, dry mouth).

Effect on later sexual function

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

Other untoward side effects of treatment

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

Efficacy of a prevention strategy

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

*The basis for the assumed risk (e.g. the median control group risk across trials) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; N/A: not applicable; RR: risk ratio.

GRADE Working Group grades of evidence
High quality: further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: we are very uncertain about the estimate.

Ephedrine 15 mg compared with placebo for stuttering priapism

Patient or population: men and boys with SCD and stuttering priapism

Settings: outpatients

Intervention: ephedrine 15 mg/30 mg once daily

Comparison: placebo

Detumescence

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

Reduction in frequency of priapism

Follow‐up: 6 months

N/A

24

(1)

⊕⊝⊝⊝
very low^1,2

No significant difference was found between ephedrine 15mg and placebo or ephedrine 30mg and placebo but there were concerns over the reliability of the published results.

Immediate side effects of treatment with 30 mg ephedrine (palpitations)

Follow‐up: 6 months

RR

1.00 (95% CI 0.32 to 3.10)

24

(1)

⊕⊝⊝⊝
very low^1,2

No significant difference was seen between ephedrine 15mg or 30mg and placebo for any of the other immediate side effects measured (lack of sleep, hand shaking, anxiety, dry mouth).

Immediate side effects of treatment with 30 mg ephedrine (tachycardia)

Follow‐up: 6 months

RR

0.67 (95% CI 0.13 to 3.30)

24

(1)

⊕⊝⊝⊝
very low^1,2

No significant difference was seen between ephedrine 15mg or 30mg and placebo for any of the other immediate side effects measured (lack of sleep, hand shaking, anxiety, dry mouth).

Effect on later sexual function

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

Other untoward side effects of treatment

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

Efficacy of a prevention strategy

Follow‐up: N/A

N/A

N/A

N/A

This outcome was not measured.

*The basis for the assumed risk (e.g. the median control group risk across trials) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; N/A: not applicable; RR: risk ratio.

GRADE Working Group grades of evidence
High quality: further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: we are very uncertain about the estimate.