Kuthe Andrea
Department of Biochemistry, University of Fribourg, Fribourg, Switzerland.
Curr Opin Urol. 2003 Sep;13(5):405-10. doi: 10.1097/00042307-200309000-00008.
Phosphodiesterase 5 inhibitors are preferred by most men for the oral treatment of erectile dysfunction. In many guidelines, this therapy is recommended as first-line therapy because of convenience, high efficacy, and low rates of side-effects. Sildenafil was the first drug for the treatment of erectile dysfunction, introduced in 1998. There are now two new phosphodiesterase 5 inhibitors, vardenafil and tadalafil, for which approval was recently given in the European Union and is expected this year in the United States.
Sildenafil has proved to be a very effective medicinal product. According to initial studies, vardenafil and tadalafil have demonstrated efficacy comparable to that of sildenafil. However, fewer data are available evaluating the adverse effects of vardenafil and tadalafil, particularly on their long-term use and their use in high-risk groups. Interestingly, vardenafil and tadalafil have a higher potency than sildenafil. Moreover, the long life of tadalafil has been associated with an erectogenic potential of the drug lasting for more than 24 h. The advantage of this is the possibility of a patient engaging in sexual activity more than once after a single administration of the drug.
In the future, in addition to sildenafil, the new phosphodiesterase 5 inhibitors vardenafil and tadalafil will play an important role in the management of erectile dysfunction, depending on the patient's health profile.
磷酸二酯酶5抑制剂是大多数男性口服治疗勃起功能障碍的首选药物。在许多指南中，由于其便利性、高效性和低副作用发生率，该疗法被推荐为一线治疗方法。西地那非是1998年推出的首个治疗勃起功能障碍的药物。目前有两种新型磷酸二酯酶5抑制剂，伐地那非和他达拉非，它们最近已在欧盟获批，预计今年在美国获批。
西地那非已被证明是一种非常有效的药物。根据初步研究，伐地那非和他达拉非已显示出与西地那非相当的疗效。然而，评估伐地那非和他达拉非不良反应的数据较少，尤其是关于它们的长期使用以及在高危人群中的使用情况。有趣的是，伐地那非和他达拉非的效力比西地那非更高。此外，他达拉非的长效性与该药物超过24小时的勃起促进潜力有关。这样做的好处是患者在单次服药后有可能进行不止一次性活动。
未来，除西地那非外，新型磷酸二酯酶5抑制剂伐地那非和他达拉非将根据患者的健康状况在勃起功能障碍的治疗中发挥重要作用。
