Topical alprostadil cream for the treatment of erectile dysfunction: a combined analysis of the phase II program.
OBJECTIVE
To present a meta-analysis of the efficacy and safety data of two recently completed Phase II studies examining a novel alprostadil topical cream for the treatment of erectile dysfunction (ED).


METHODS
Patients (n = 303) with ED of at least 3 months' duration were randomized to receive placebo or 50, 100, 200, or 300 microg alprostadil in two nearly identical 11-dose, multicenter, at-home studies of a novel topical cream containing alprostadil and a proprietary skin permeation enhancer. The primary efficacy endpoint was the change in erectile function domain score from baseline to the final visit. Secondary endpoints included changes in scores for questions 3 and 4 of the International Index of Erectile Function and standard diary analyses. Safety was assessed by analysis of adverse events, changes in laboratory test results, and physical examination findings.


RESULTS
The mean baseline parameters for the erectile function score, ED history, and secondary diagnoses suggested no significant differences among the treatment groups. The changes from baseline to the final visit erectile function scores were 0.98 +/- 0.84, 3.4 +/- 1.3, 3.4 +/- 0.88 (P <0.05), 5.3 +/- 0.92 (P <0.001), and 9.4 +/- 1.43 (P <0.001) for the ascending dose groups. Most secondary efficacy endpoints were significant for the 200 and 300-microg dose groups. Dose-related trends in efficacy were observed. Adverse events were localized to the application site, were of mild or moderate intensity, and were of short duration.


CONCLUSIONS
These results suggest topical alprostadil cream, when combined with a novel dermal permeation-enhancer, to be a potentially useful agent for the treatment of ED.
Steidle
Christopher
C
Northeast Indiana Research, Fort Wayne, Indiana, USA.
Padma-Nathan
Harin
H
Salem
Shawki
S
Tayse
Natalie
N
Thwing
Denise
D
Fendl
Jane
J
Yeager
James
J
Harning
Ronald
R
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000527:Alprostadil / Q000008:administration & dosage*; D000704:Analysis of Variance; D017322:Clinical Trials, Phase II as Topic; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D000527:Alprostadil