Anti-Inflammatory Priming Enhances the Anti-Erectile Dysfunction Efficacy of PDE5 Inhibitors | Chapter 18 | Issues and Developments in Medicine and Medical Research Vol. 3

 Background: Evidence for the role of low-grade systemic inflammation as a co-determinant of erectile dysfunction has been accumulating for some time. Inflammation and disturbance of local microcirculation may potentially prevent PDE5 (phosphodiesterase type 5) inhibitors from working to their full potential. The goal of the idea-generating pilot study described here was to see if reducing such pro-inflammatory contributions to the erectile dysfunctional milieu with the use of a food supplement could improve PDE5 drug efficacy.

Methods: Study Design: Prospective cohort pilot study (14 patients diagnosed with moderate erectile dysfunction) with an end-of-study comparison of final treatment outcomes vs. a random sample of recent history ED (erectile dysfunction) controls from the author's urology ward.

Treatment in a Group Background anti-inflammatory priming for one month (one 1-g tablet once day) with a dietary supplement with known anti-inflammatory and capillary protecting effects, followed by three months of alternating every-other-day treatment with 25-mg sublingual sildenafil or the dietary supplement.

Assessments included a purely exploratory comparison of the prospective cohort's end-of-study EEIF-5 mean scores with a sample of historical controls, as well as a comparison of the overall skewness of the cohort distribution of IIEF-5 (simplified International Index of Erectile Function) scores before and after the treatment period.

The IIEF-5 frequency distribution had a strong left skewness towards the end of the research when compared to the basal score distribution, indicating that reducing background inflammation could be beneficial. Prospective active cohort EEIF-5 mean scores vs. ED historical controls: 20.4 vs. 14.0.

Conclusions: The exploratory comparison of end-of-treatment mean IIEF-5 scores in the active cohort vs historic controls provides preliminary support for the idea that modifying the pro-inflammatory erectile dysfunctional milieu with the anti-inflammatory dietary supplement may have contributed to the overall efficacy of the anti-ED treatment and improved the 3-month efficacy of sublingual sildenafil. Further research is required to corroborate these early findings.

Author(S) Details

Ninfa Alessandra Giacalone
Urology Operative Unit, “Istituto G. Giglio” Foundation, Cefalù, Sicily, Italy.

Francesco Curto
Urology Operative Unit, “Istituto G. Giglio” Foundation, Cefalù, Sicily, Italy.

Mauro Raichi
Clinical Pharmacology, Bioinformatics and Statistics Consultant, Milan, Italy.

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