Phosphodiesterase-5 inhibitors: future perspectives.
PDE-5 inhibitors were originally studied in cardiovascular indications but were later developed and approved for on-demand treatment of erectile dysfunction (ED). A few years ago sildenafil was approved for the treatment of pulmonary hypertension, thus renewing interest in cardiovascular applications, and tadalafil became available in once-daily formulations for erectile dysfunction management. Given the wide distribution of phosphodiesterase-5 throughout the body and its involvement in multiple functions, what can one expect in the future? To answer this we reviewed studies involving PDE-5 inhibitors that were published within the past three years and searched the US National Institutes of Health clinical trial registry for ongoing ones. PDE-5 inhibitors are being actively investigated in many disease states, with interest focusing mainly on urology and cardiovascular medicine. In urology erectile dysfunction is the primary target, followed by BPH-related lower urinary tract symptoms. As far as cardiovascular medicine is concerned, treatment of heart failure is the indication where PDE-5 inhibitors seem to be closer to clinical application but preclinical data also support a role in cardiac preconditioning.
University Hospital of Patras, Urology Dept, Building A, 4th floor, Patras, 26500, Greece. giannitsaskon@yahoo.com
Giannitsas
G
Konstantinos
Perimenis
P
Petros
D000818:Animals; D007172:Erectile Dysfunction / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D058986:Phosphodiesterase 5 Inhibitors; D010726:Phosphodiesterase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D011247:Pregnancy; D014570:Urologic Diseases / Q000188:drug therapy
D058986:Phosphodiesterase 5 Inhibitors; D010726:Phosphodiesterase Inhibitors