Co-administration of low doses of intranasal PT-141, a melanocortin receptor agonist, and sildenafil to men with erectile dysfunction results in an enhanced erectile response

Diamond, Lisa E.; Earle, Dennis; García, Wilson; Spana, Carl

doi:10.1016/j.urology.2004.10.060

Cited by 37 publications

(22 citation statements)

References 17 publications

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“…A number of clinical studies have evaluated the effect of PT-141 (Molinoff et al, 2003;Diamond et al, 2004Diamond et al, , 2005Rosen et al, 2004). PT-141 was administered intranasally at doses ranging from 4 to 20 mg to 32 healthy subjects in a randomized, double-blind, placebocontrolled crossover study .…”

Section: Drugs For Nonintracavernosal Administrationmentioning

confidence: 99%

“…A randomized, prospective placebo-controlled crossover study compared treatment of 19 patients with ED with sildenafil (25 mg) alone versus sildenafil (25) with 7.5 mg of intranasal PT-141 (Diamond et al, 2005). Coadministration of the two agents resulted in significantly prolonged time of increased base rigidity (Ͼ60%) compared with sildenafil alone during a 2.5-h monitoring session.…”

Section: Drugs For Nonintracavernosal Administrationmentioning

confidence: 99%

See 1 more Smart Citation

Mechanisms of Penile Erection and Basis for Pharmacological Treatment of Erectile Dysfunction

2011

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Section: Drugs For Nonintracavernosal Administrationmentioning

confidence: 99%

Section: Drugs For Nonintracavernosal Administrationmentioning

confidence: 99%

Mechanisms of Penile Erection and Basis for Pharmacological Treatment of Erectile Dysfunction

2011

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“…40 Its intranasal administration along with simultaneous PDE5I use demonstrated a statistically significant increased erectile response as documented by RigiScan when compared with placebo groups. 41 A pilot study combining trazodone (a non-tricyclic antidepressant) and sildenafil has yielded promising results in PDE5I monotherapy nonresponders; however, study limitations include small sample size and lack of a control group. 42 Pentoxifylline, a methylxanthine derivative used in peripheral arterial disease, now believed to have an antifibrotic effect, has been effectively combined with PDE5I to significantly Combination therapy for erectile dysfunction R R Dhir et al 387…”

Section: Pde5i Plus Other Medicationsmentioning

confidence: 99%

Combination therapy for erectile dysfunction: an update review

Dhir¹,

Lin

Canfield³

et al. 2011

Asian J Androl

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The introduction of oral phosphodiesterase-5 inhibitors (PDE5Is) in the late 1990s and early 2000s revolutionized the field of sexual medicine and PDE5Is are currently first-line monotherapy for erectile dysfunction (ED). However, a significant proportion of patients with complex ED will be therapeutic non-responders to PDE5I monotherapy. Combination therapy has recently been adopted for more refractory cases of ED, but a critical evaluation of current combination therapies is lacking. A thorough PubMed and Cochrane Library search was conducted focusing on the effectiveness of combination therapies for ED in therapeutic non-responders to PDE5I therapy. Journal articles spanning the time period between January 1990 and December 2010 were reviewed. Criteria included all pertinent review articles, randomized controlled trials, cohort studies and retrospective analyses. References from retrieved articles were also manually scanned for additional relevant publications. Published combination therapies include PDE5I plus vacuum erectile device (VED), intraurethral medication, intracavernosal injection (ICI), androgen supplement, a-blocker or miscellaneous combinations. Based on this review, some of these combination treatments appeared to be quite effective in preliminary testing. Caution must be advised, however, as the majority of combination therapy articles in the last decade have numerous limitations including study biases and small subject size. Regardless of limitations, present combination therapy research provides a solid foundation for future studies in complex ED management. 1 Current projections indicate an increase in the prevalence of ED due to aging as well as the continued abundance of comorbidities such as coronary artery disease, hypertension and diabetes in industrialized nations. Over 320 million people in Westernized nations will be affected by 2025, more than double the prevalence seen 15 years ago, indicating a growing need to reevaluate ED therapeutic strategies.2 Over the past four decades, the treatment of ED has evolved rapidly and is still changing with new discovery. Before the 1970s, psychotherapy was the primary means of treatment and undoubtedly was limited in its success. During the 1970s, penile prostheses combined with psychotherapy remained popular but relatively inaccessible. The 1980s was dominated by intracavernous injection (ICI) and followed by intraurethral therapy in the mid-1990s. Despite this transition towards non-surgical management, available treatment modalities were not patient-friendly. The introduction of oral phosphodiesterase-5 inhibitors (PDE5Is) in the late 1990s and early 2000s revolutionized the field of sexual medicine and PDE5Is are currently first-line monotherapy.

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“…47 Comorbidities of this population included smoking, obesity, diabetes mellitus, hypertension and hyperlipidemia. In this randomized, crossover study design, patients were provided with a single dose of 25 mg sildenafil and 7.5 mg intranasal bremelanotide, 25 mg sildenafil and an intranasal placebo spray, or a placebo tablet and an intranasal placebo spray.…”

Section: Melanocortinsmentioning

confidence: 99%

“…Several early clinical trials have been reported on the efficacy and safety of bremelanotide in males with ED, both as monotherapy and in combination with sildenafil. [45][46][47] Two Phase 1 safety studies of bremelanotide have been conducted in healthy volunteers. 45,46 One study provided bremenalotide subcutaneously, whereas the second used the intranasal formulation that has been chosen for further clinical development.…”

Section: Melanocortinsmentioning

confidence: 99%

Clinical applications of centrally acting agents in male sexual dysfunction

Hellstrom

2008

Int J Impot Res

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Currently available agents for erectile dysfunction (ED) share the same mechanism of action and pharmacologic properties. Therefore, they share the same limitations, including a principal focus on erection as an end-organ process. One of the relatively unexplored areas of research has been the potential for centrally acting agents to improve male sexual response. A variety of neurohormones and neurotransmitter systems are involved in the male sexual response, including testosterone, dopamine, serotonin and the melanocortin systems. Investigations to determine the utility of centrally acting agents as monotherapy or adjunctive therapy in men with ED or other forms of sexual dysfunction are underway. Bremelanotide, a melanocortin agonist, has been tested in men with ED and may prove to be one of the first centrally acting agents to have clinical utility in male sexual dysfunction.

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Co-administration of low doses of intranasal PT-141, a melanocortin receptor agonist, and sildenafil to men with erectile dysfunction results in an enhanced erectile response

Cited by 37 publications

References 17 publications

Mechanisms of Penile Erection and Basis for Pharmacological Treatment of Erectile Dysfunction

Mechanisms of Penile Erection and Basis for Pharmacological Treatment of Erectile Dysfunction

Combination therapy for erectile dysfunction: an update review

Clinical applications of centrally acting agents in male sexual dysfunction

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