Men with type 2 diabetes randomly assigned to dulaglutide versus placebo had a lower incidence of erectile dysfunction, an exploratory analysis showed.

"The finding that dulaglutide reduced the occurrence of moderate or severe erectile dysfunction in the REWIND (Researching Cardiovascular Events with a Weekly Incretin in Diabetes) trial adds to a growing list of long-term preventive effects of GLP-1 receptor agonists in general and dulaglutide in particular," Dr. Hertzel Gerstein of McMaster University in Hamilton, Ontario told Reuters Health by email.

"This is consistent with the previously published reduction in strokes, heart attacks, cardiovascular death and kidney outcomes by this glucose-lowering drug, as well as benefits on cognitive decline," he said. "Taken together, these effects suggest that this drug improves small and large blood vessel health. Future research will continue to explore the health benefits of this and similar drugs."

As reported in The Lancet Diabetes and Endocrinology, REWIND was conducted at 371 sites in 24 countries. Men and women aged older than 50 with type 2 diabetes, who had either a previous cardiovascular event or cardiovascular risk factors, were randomly assigned (1:1) to receive either dulaglutide or placebo.

Participating men were offered the opportunity to complete the standardized International Index of Erectile Function questionnaire at baseline, two years, five years, and study end.

The exploratory analysis included 3,725 (70.1% of male participants) with a mean age of 65.5; 39.9% had a history of cardiovascular disease and 56.5% had moderate or severe erectile dysfunction at baseline.

The incidence of erectile dysfunction 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).

Findings were similar in subgroups defined on the basis of age, baseline erectile function score below or less than or equal to the median value of 14, or baseline use of beta-blocker or erectile dysfunction therapies.

Of note, there was a lower incidence of erectile dysfunction in men taking dulaglutide for the subgroup with previous cardiovascular disease (HR 0.81) than for those without.

Men taking dulaglutide also had a lesser fall in the erectile function subscore (16 or less) compared with placebo, with a least square mean difference of 0.61.

The authors conclude, "Long-term use of dulaglutide might reduce the incidence of moderate or severe erectile dysfunction in men with type 2 diabetes."

Dr. Ronald Tamler, Director of Digital Health Implementation at Mount Sinai Health System in New York City, commented on the study in an email to Reuters Health, "We have long known men with diabetes who improve their blood sugars often notice improved erectile function. The same goes for obese men in general who lose weight, preferably by exercise. It is a welcome development but not a complete surprise, that a medication which addresses both diabetes and obesity could have this added benefit."

The study was funded by Eli Lilly and Company. Dr. Gerstein and a number of the coauthors received fees from the company.

SOURCE: https://bit.ly/3e1HbJs and https://bit.ly/2Vg1YCD Lancet Diabetes and Endocrinology, online June 18, 2021.