Literature DB >> 18445362

Effects of pioglitazone on erectile dysfunction in sildenafil poor-responders: a randomized, controlled study.

Babak Gholamine1, Massoumeh Shafiei, Manijeh Motevallian, Massoud Mahmoudian.   

Abstract

PURPOSE: The effects of pioglitazone on sildenafil responsiveness in men with erectile dysfunction(ED) and a history of poor response to sildenafil were assessed.
METHODS: In a double-blinded study,38 men aged 47 +/- 1.5 years with moderate-to severe ED and poor response to sildenafil were randomly assigned to take a premedication of pioglitazone 30 mg (n=19) or placebo (n=19) once daily for 9 weeks along with on-demand use of sildenafil during the last month of pioglitazone treatment.Erectile function (EF) scores, assessed by EF domain of International Index of Erectile Function (IIEF), along with responses to Global Assessment Questions (GAQs) were major outcome measures. Serum levels of total testosterone (T),dehydroepiandrosterone sulfate (DHEAS), glucose,lipid profile and liver function test were minor outcome measures.
RESULTS: Pioglitazone significantly improved major outcome measures compared with placebo. The decrease from baseline of total cholesterol level was more in pioglitazone than in placebo-treated groups. In 84% (32 out of 38) of the sildenafil poor-responders, at least one of the associated risk factors of ED was found. There was undiagnosed hypercholesterolemia in 34% of the subjects. Serum levels of T, DHEAS, glucose and other parameters remained unchanged in both groups. The intervention was well tolerated.
CONCLUSIONS: Pioglitazone increased sildenafil response to improve ED of men with prior sildenafil failure and seems to be safe based on the present preliminary study. This improvement is likely regardless of fasting glucose and sex hormones levels.

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Year:  2008        PMID: 18445362     DOI: 10.18433/j3tg6h

Source DB:  PubMed          Journal:  J Pharm Pharm Sci        ISSN: 1482-1826            Impact factor:   2.327


  9 in total

1.  Non-invasive management of primary phosphodiesterase type 5 inhibitor failure in patients with erectile dysfunction.

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2.  Effects of Ginkgo biloba extracts with mirodenafil on the relaxation of corpus cavernosal smooth muscle and the potassium channel activity of corporal smooth muscle cells.

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Review 3.  Erectile dysfunction and diabetes: A melting pot of circumstances and treatments.

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4.  Acute effect of rosiglitazone on relaxation responses in hypercholesterolemic corpus cavernosum.

Authors:  H Akdag; N Murat; S Evcim; A Esen; S Gidener
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5.  Risk management in the treatment of type 2 diabetes with pioglitazone.

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Journal:  Diabetes Metab Syndr Obes       Date:  2009-07-01       Impact factor: 3.168

6.  Sildenafil does not enhance but rather attenuates vasorelaxant effects of antidiabetic agents.

Authors:  Jacob D Peuler; Laura E Phelps
Journal:  J Smooth Muscle Res       Date:  2015

7.  Clinical Practice Guidelines for management of Sexual Disorders in Elderly.

Authors:  T S Sathyanarayana Rao; Abhinav Tandon; Shivanand Manohar; Supriya Mathur
Journal:  Indian J Psychiatry       Date:  2018-02       Impact factor: 1.759

Review 8.  Toward a new 'EPOCH': optimising treatment outcomes with phosphodiesterase type 5 inhibitors for erectile dysfunction.

Authors:  R Sadovsky; G B Brock; S W Gutkin; S Sorsaburu
Journal:  Int J Clin Pract       Date:  2009-08       Impact factor: 2.503

9.  Effects and Mechanism of Action of a Tribulus terrestris Extract on Penile Erection.

Authors:  Jungmo Do; Seemin Choi; Jaehwi Choi; Jae Seog Hyun
Journal:  Korean J Urol       Date:  2013-03-15
  9 in total

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