An update on new oral PDE5 inhibitors for the treatment of erectile dysfunction

The management of erectile dysfunction (ED) has been revolutionized by the discovery of phosphodiesterase 5 (PDE5) inhibitors, which have been commercially available for more than a decade

and are the first-line therapeutic option for men with ED. Sildenafil, vardenafil and tadalafil were approved by the European Medicine Agency and the US FDA for the treatment of ED on the

back of their high efficacy rates and favorable safety profiles. However, despite the fact that more than 50 million patients with ED worldwide have been successfully treated with one of

these PDE5 inhibitors, some men—most notably those with severe neurologic damage, diabetes mellitus or severe vascular disease—are resistant to the currently available drugs and require

more-invasive treatments, such as intracavernosal injection therapy. Partly as a consequence of this, research into alternative therapeutic approaches continues, including the development of

new PDE5 inhibitors, centrally acting pharmaceutical agents, and application of molecular technologies such as gene therapy and stem cell therapy.

Phosphodiesterase type 5 (PDE5) inhibitors remain the first-line therapy for most men with erectile dysfunction (ED)

The currently available PDE5 inhibitors (sildenafil, vardenafil and tadalafil) are all highly effective and well tolerated

New PDE5 inhibitors under clinical development differ from established agents mainly in terms of their pharmacokinetics, and possibly in relation to their selectivity

Other approaches to the treatment of ED include the use of centrally acting agents, gene therapy and stem cell therapy; such approaches are currently some way away from everyday clinical

practice

Both authors contributed equally to researching data for the article, discussing the content, writing, and review/editing of the manuscript before submission.

I. Eardley has acted as a consultant for Eli Lilly and Company and Bayer Schering Pharma, and has received speakers' bureau (honoraria) and grant-research support from Pfizer, Eli Lilly and

Company and Bayer Schering Pharma. V. Palit declares no competing interests.

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