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Does the clinical efficacy of vardenafil correlate with its effect on the endothelial function of cavernosal arteries? A pilot study
Author(s) -
Mazo Evsey B.,
Gamidov Safar I.,
Iremashvili Vyacheslav V.
Publication year - 2006
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06433.x
Subject(s) - vardenafil , erectile dysfunction , medicine , cgmp specific phosphodiesterase type 5 , erectile function , urology , cardiology , endothelial dysfunction , artery , tadalafil
OBJECTIVE To investigate whether the results of the ultrasonographic (US) measurement of post‐occlusive changes in the diameters of cavernosal arteries after administering phosphodiesterase type 5 (PDE‐5) inhibitor vardenafil could be associated with the response to vardenafil in patients with erectile dysfunction (ED), as currently there are no reliable methods for predicting the success rate of oral PDE‐5 inhibitors. PATIENTS AND METHODS The study included 122 men with ED; after a complex evaluation, the endothelial function of the cavernosal arteries was assessed in all patients before and 1 h after oral ingestion of vardenafil (20 mg), using our modification of the US assessment of post‐occlusive changes in the diameter of cavernosal arteries. After the evaluation, all patients received vardenafil 20 mg on demand for 4 weeks. A successful response was defined using two endpoints, i.e. the normalization of the International Index of Erectile Function Erectile Function domain score (≥26) and positive answers to both Sexual Encounter Profile questions 2 and 3 on ≥ 75% of occasions, based on the diary data collected. RESULTS In all patients the mean ( sd ) initial percentage increase in the cavernosal artery diameter (PICAD) in responders and nonresponders was not statistically different, at 49 (24) and 43 (26), respectively ( P = 0.168), but PICAD values after vardenafil were significantly greater in responders, at 73 (16) vs 55 (23) ( P < 0.001). Analysis of data from patients with different causes of ED showed statistically significant differences in PICAD between responders and nonresponders only in those with arteriogenic ED. The sensitivity and specificity of a PICAD of ≥ 50% after taking vardenafil 20 mg for predicting a positive response to the same dose of the drug in patients with arteriogenic ED were 94.9% and 91.3%, respectively. CONCLUSION The results of the US assessment of post‐occlusive changes in the diameter of cavernosal arteries after vardenafil administration are significantly associated with the clinical efficacy of the drug in patients with arteriogenic ED.