Addressing unmet needs for patients with erectile dysfunction: a narrative review of topical therapies.

IF 2.6 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Sexual Medicine Pub Date : 2025-05-12 eCollection Date: 2025-04-01 DOI:10.1093/sexmed/qfaf021
Gerald B Brock, Wayne J G Hellstrom, Annamaria Giraldi, Stanton Honig
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引用次数: 0

Abstract

Background: Treatment of patients with erectile dysfunction (ED) was revolutionized by the development and approval of phosphodiesterase type 5 inhibitors (PDE5is), which have been repeatedly shown to be safe and effective in men with this condition. However, some patients do not respond to these agents and others may prefer an alternative therapy.

Aim: The objective of this paper is to evaluate topical therapies for ED used in clinical studies, either as single agents or in combination with a PDE5i, and consequently determine which topical therapies meet the criteria of an 'ideal medication for ED.'

Methods: The PubMed database was searched to identify clinical studies of topical agents that have been evaluated in men with ED. This review was supplemented by a search of presentations at the 2024 annual meetings of the American Urological Association and Sexual Medicine Society of North America.

Results: The literature review and subsequent screening resulted in 39 clinical studies and 5 meeting abstracts for review. The studies demonstrated efficacy for intraurethral and topical alprostadil, topical prostaglandin E1 ethyl ester, nitric oxide donors, testosterone (in selected patients), and a non-medicated hydro-alcoholic gel. The studies reviewed also demonstrated a significant benefit of adding topical alprostadil to therapy in patients with inadequate responses to PDE5is. An effective topical therapy delivered to its site of action with a rapid onset could improve patients' and partners' satisfaction with and acceptance of treatment. These actions have been demonstrated by a new over-the-counter agent, MED3000, authorized by the United States Food and Drug Administration, and for topical alprostadil, which is available with a prescription in the European Union.

Clinical translation: The availability of safe and effective topical ED therapy is an important addition to current treatment options for men with this condition.

Strengths and limitations: This study provides results from a comprehensive search strategy by including a wide range of search criteria. However, the heterogeneity of studies evaluated creates difficulties in directly comparing results from different studies.

Conclusion: The results of this analysis show that current topical therapies can provide statistically and clinically significant improvements in erectile function in men with ED and may provide an effective alternative to PDE5i in men who require or prefer an alternative therapy.

解决勃起功能障碍患者未满足的需求:局部治疗的叙述性回顾。
背景:磷酸二酯酶5型抑制剂(PDE5is)的开发和批准彻底改变了勃起功能障碍(ED)患者的治疗,PDE5is已被反复证明对男性勃起功能障碍患者安全有效。然而,一些患者对这些药物没有反应,而另一些患者可能更喜欢替代疗法。目的:本文的目的是评估在临床研究中使用的ED局部治疗方法,无论是单独使用还是与PDE5i联合使用,从而确定哪种局部治疗方法符合“ED理想药物”的标准。检索PubMed数据库,以确定已对男性ED进行评估的局部用药的临床研究。本综述还检索了美国泌尿学会和北美性医学学会2024年年会上的报告。结果:文献回顾和随后的筛选得到39个临床研究和5个会议摘要供回顾。这些研究证实了经尿道和外用前列地尔、外用前列腺素E1乙酯、一氧化氮供体、睾酮(在选定的患者中)和非药物水酒精凝胶的有效性。回顾的研究还表明,在对pde5反应不足的患者治疗中,局部添加前列地尔有显著的益处。快速起效的局部治疗可提高患者及其伴侣对治疗的满意度和接受度。经美国食品和药物管理局批准的一种新的非处方药MED3000以及在欧盟可凭处方获得的局部前列地尔就证明了这些作用。临床翻译:安全有效的局部ED治疗的可用性是对患有这种疾病的男性当前治疗选择的重要补充。优势和局限性:本研究提供了一个全面的搜索策略,包括广泛的搜索标准的结果。然而,评估研究的异质性造成了直接比较不同研究结果的困难。结论:本分析结果表明,目前的局部治疗可以在统计学和临床上显著改善ED患者的勃起功能,并可能为需要或倾向于替代治疗的男性提供PDE5i的有效替代治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Sexual Medicine
Sexual Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
5.40
自引率
0.00%
发文量
103
审稿时长
22 weeks
期刊介绍: Sexual Medicine is an official publication of the International Society for Sexual Medicine, and serves the field as the peer-reviewed, open access journal for rapid dissemination of multidisciplinary clinical and basic research in all areas of global sexual medicine, and particularly acts as a venue for topics of regional or sub-specialty interest. The journal is focused on issues in clinical medicine and epidemiology but also publishes basic science papers with particular relevance to specific populations. Sexual Medicine offers clinicians and researchers a rapid route to publication and the opportunity to publish in a broadly distributed and highly visible global forum. The journal publishes high quality articles from all over the world and actively seeks submissions from countries with expanding sexual medicine communities. Sexual Medicine relies on the same expert panel of editors and reviewers as The Journal of Sexual Medicine and Sexual Medicine Reviews.
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