title: Avanafil - a further step to tailoring patient needs and expectations.
abstract: BACKGROUND
  Phosphodiesterase type 5 inhibitors (PDE5Is) represent the first-line treatment for erectile dysfunction (ED). Almost one in two patients, however, show some level of treatment dissatisfaction and up to 30% fail to respond to any of the currently available PDE5Is. Recently, the second-generation PDE5I avanafil was launched for the treatment of ED.
  
  
  METHODS
  Pivotal studies of clinical development along with placebo-controlled randomized clinical trials (RCTs) of avanafil in patients with ED were reviewed. Studies concerning the pharmacokinetics and pharmacodynamic of the drug were also analysed. A systematic literature search for English-language studies published up to May 2016 using the Medline database was performed. The search included the terms avanafil and ED. Expert commentary: Avanafil is a potent, highly selective PDE5I whose efficacy is comparable to that of currently available PDE5Is in both naïve and previous PDE5I users. Avanafil is effective within approximately 15 minutes of dosing, thus representing the only PDE5I approved for as-needed use, 15 to 30 minutes before sexual activity. Avanafil has high selectivity for the PDE5 isoenzyme, thus resulting in a lower incidence of drug-related side effects compared to other PDE5Is.
authors.affiliation: a Division of Experimental Oncology/Unit of Urology , URI, IRCCS Ospedale San Raffaele , Milan , Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Boeri
authors.affiliation: b Università Vita-Salute San Raffaele & Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele , Milan , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Capogrosso
authors.affiliation: b Università Vita-Salute San Raffaele & Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele , Milan , Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Ventimiglia
authors.affiliation: a Division of Experimental Oncology/Unit of Urology , URI, IRCCS Ospedale San Raffaele , Milan , Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Serino
authors.affiliation: b Università Vita-Salute San Raffaele & Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele , Milan , Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: La Croce
authors.affiliation: b Università Vita-Salute San Raffaele & Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele , Milan , Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Russo
authors.affiliation: c Department of Urology , Research Doctorate Program in Urology, Magna Graecia University , Catanzaro , Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Damiano
authors.affiliation: b Università Vita-Salute San Raffaele & Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele , Milan , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.affiliation: b Università Vita-Salute San Raffaele & Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele , Milan , Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Salonia
mesh_terms: D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D058986:Phosphodiesterase 5 Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D011743:Pyrimidines / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D058986:Phosphodiesterase 5 Inhibitors; D011743:Pyrimidines; C553414:avanafil
keywords: Erectile dysfunction; avanafil; phosphodiesterase type 5 inhibitors; selectivity; therapy