PDE5 Inhibitor Treatment Options for Urologic and Non-Urologic Indications: 2012 Update
Philip J. Kadowitz,
Ege Can Serefoglu,
Wayne J.G. Hellstrom.
Phosphodiesterase (PDE) enzymes are widely distributed throughout the body, having numerous effects and functions. The use
of on demand PDE5 inhibitors (-Is) for the treatment of erectile dysfunction (ED) has recently obtained approval for chronic daily dosing
for the same indication. There are published data supporting the use of PDE5-Is for the treatment of lower urinary tract symptoms
(LUTS) caused by benign prostatic hyperplasia (BPH). Additional reports suggest benefit by these agents in patients with chronic heart
failure, pulmonary hypertension, essential hypertension, and for the treatment of ischemia. Various central nervous system disorders have
been described as targets by PDE5-Is. Sildenafil may have a potential therapeutic indication as a cognitive enhancer in age-related cerebral
conditions. There is preclinical evidence for further investigation of the use of PDE5A -Is to improve recovery of cerebral function in
humans after stroke by enhancing angiogenesis, neurogenesis and improving neurologic function. Sildenafil delays intestinal ulceration
by an increase in the secretion of mucus/fluid and a decrease in hypermotility, and has a protective effect in reducing gastric damage.
Larger scale, well designed clinical trials are needed to ascertain the safety, efficacy and cost-effectiveness of PDE5-Is in the future
treatment of both urologic and non-urologic diseases. In this review, potential applications of PDE5-Is on urologic, cardiovascular, gastrointestinal,
and central nervous system disorders will be updated.
Keywords: Phoshodiesterase enzyme, sildenafil, stroke, cardiovascular disease, pulmonary hypertension, priapism, erectile dysfunction (ED), hypermotility, ischemia, central nervous system disorders.
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