Casey Balslev posted an update 1 year ago
124 , 125 Data from several small clinical trials suggest that PDE5 inhibitors may be used successfully for the treatment of priapism. 123 There is currently no clinical data to support the use of PDE5 inhibitors for the treatment of PD. Therefore, a future goal should be to confirm the existing in vitro and in vivo preclinical evidence in clinical trials to evaluate the potential of PDE5 inhibitors for the treatment of PD. However, patients treated with Fildena reported significantly increased ejaculatory control, increased ejaculatory confidence and had a decreased post-ejaculatory erectile refractory time.
98 However, as yet, clinical data to support the use of PDE5 inhibitors for the treatment of OAB are limited. 92 , 93 , 94 , 95 As these effects are relatively weak, there is increasing evidence that the effects of PDE5 inhibitors are at least in part related to their influence on the urothelium. 17 , 81 Even more striking are the recent observations from clinical studies, where a reduction of LUTS was reported in patients with BPH treated with Fildena and Fildena.
61 , 62 Thus, it is logical to expect that PDE5 inhibitors may improve vaginal and clitoral blood flow and facilitate arousal and orgasm in women. Nevertheless, one has to keep in mind that due to the lack of clinical data the use of PDE5 inhibitors is not indicated in stroke patients 6 months after acute stroke. Few studies have been published on the effects of Fildena on cerebral blood flow (CBF) and oxygenation, and results are controversial.
The effects of PDE5 inhibitors on memory processes in humans have only been studied sporadically. 44 Moreover, oral administration of the PDE5 inhibitors Fildena and vardenafil (1-10 mg/kg) immediately after training effectively improved the memory performance of rats in object recognition tasks. Effects of PDE5 inhibitors on learning and memory.
The presence of PDE5 in the CNS might explain why PDE5 inhibitor treatment may result in some degree of back pain and myalgia as side effects of therapy. PDEs are abundantly expressed in central nervous system (CNS) tissue 34 and there are an increasing number of reports on the effects of PDE5 inhibitors on the CNS. It is not clear to what extent the vascular effects of PDE5 inhibitors affect coronary and left ventricular hemodynamics.
26 These findings were confirmed by Hryniewicz et al., 27 who compared Fildena with the angiotensin-converting enzyme inhibitor ramipril, showing that both compounds improved flow-mediated dilation to a similar extent in patients with heart failure. There are numerous potential mechanisms by which PDE5 inhibitors could exert positive effects on the course and symptoms of this disease. 22 On the basis of these data, Fildena was approved in 2005 by the United States Food and Drug Administration and the European Agency for the Evaluation of Medicinal Products for the treatment of patients with PAH.