a Department of Urology , University Hospitals Leuven , Leuven , Belgium.
b Department of Surgery, Division of Urology , University of Western Ontario , London , ON , Canada.
Expert Opin Emerg Drugs. 2018 Dec;23(4):319-330. doi: 10.1080/14728214.2018.1552938. Epub 2018 Dec 10.
: Erectile dysfunction is an extremely frequent and extensively studied condition, currently affecting the lives of tens of millions of men around the globe. The extensive knowledge of its pathophysiology has led to the development of phosphodiesterase 5-inhibitors, which can facilitate sexual intercourse in a large number of patients. However, an ever-increasing number of patients is unresponsive to these drugs due to underlying comorbidities or previous surgery. Different molecular pathways need to be addressed to provide treatment for a larger patient population. : In this paper, we will review the underlying molecular pathways, discuss already available treatment options and their limitations and provide an overview of the newest therapeutics in development. Centrally and peripherally acting agents will be discussed separately. Additionally, newest advances in regenerative medicine options will be discussed. : Even though novel drugs have not been tested in a phase III setting, several phase II clinical trial results are eagerly awaited. These newest therapeutics could be applied as monotherapy or combination therapy in the subset of patients unresponsive to traditional treatment options.
勃起功能障碍是一种极其常见和广泛研究的疾病,目前影响着全球数千万男性的生活。对其病理生理学的广泛了解导致了磷酸二酯酶 5 抑制剂的发展,这些抑制剂可以使大量患者进行性交。然而,由于潜在的合并症或先前的手术,越来越多的患者对这些药物没有反应。需要针对不同的分子途径为更大的患者群体提供治疗。
在本文中,我们将回顾潜在的分子途径,讨论已经存在的治疗选择及其局限性,并概述正在开发的最新治疗方法。将分别讨论中枢和外周作用的药物。此外,还将讨论再生医学选择的最新进展。
尽管新型药物尚未在 III 期临床试验中进行测试,但人们热切期待着几项 II 期临床试验结果。这些最新的治疗方法可以作为单一疗法或联合疗法应用于对传统治疗方法无反应的患者亚组。