The Real-Life Safety and Efficacy of Vardenafil

Erectile dysfunction in Arab countries. Part II: Diagnosis and treatment

Objective

To review local published data on the diagnosis and treatment of erectile dysfunction (ED) in Arab countries.

Methods

MEDLINE was searched for English-language articles published from 2000 to 2011, using the search terms ‘Arab countries’, ‘sexual dysfunction’, ‘diagnosis’ and ‘treatment’.

Results

In all, 86 articles were found to be relevant to this review; only a few had a high level of evidence and the remaining studies used an uncontrolled design. Several local studies were consistent with previous reports showing that a customised diagnostic pathway, with full consideration of the patient’s goals, is adopted by most clinicians to treat ED. For an effective treatment, the evaluation methods should answer important questions about the aetiology and severity of ED, as well as the patient’s and partner’s goals and expectations. As ED is known to be associated with many common medical comorbidities and medications, careful questioning can yield information about peripheral vascular disease, coronary artery disease, diabetes, hypertension, dyslipidaemia, and tobacco and alcohol use. The presence of psychological, neurological or chronic debilitating diseases can direct further evaluation.

Conclusion

The methods used for the diagnosis and treatment of ED need more investigation, especially in Arab countries. Only a few studies addressed the results of different methods of investigating and treating ED among Arab men.

Vardenafil for the treatment of erectile dysfunction: an overview of the clinical evidence

Many men with erectile dysfunction (ED) also have associated underlying cardiovascular and metabolic conditions, for which they are likely to be taking medication. Therefore, cardiovascular safety and potential drug interactions are two of the major concerns when using PDE-5 inhibitors in these patients. The PDE-5 inhibitor, vardenafil, is characterized by a rapid onset of action, increased duration of erection, high rates of first-dose success and reliable efficacy that can be maintained with continued use. In both clinical trials and real-life observational studies, vardenafil has demonstrated a favorable efficacy and safety profile in men with ED, including those with associated underlying conditions such as diabetes, hypertension and dyslipidemia. Importantly, the concomitant use of medication for these conditions is not associated with any noteworthy changes in the efficacy and safety of vardenafil. The evidence presented in this review supports the use of vardenafil as a first-line treatment for men with ED, including those with underlying conditions.

A double-blind, placebo-controlled, randomized clinical study of the effects of vardenafil on human nasal patency

BACKGROUND

Vardenafil, a selective phosphodiesterase 5 (PDE5) inhibitor, may affect nasal patency because of its adverse-effect profile. This double-blind, placebo-controlled, randomized clinical study sought to assess the effect of vardenafil on nasal patency in patients at a university hospital.

METHODS

Nasal patency was assessed using a visual analog score and by measuring the minimum cross-sectional areas (MCAs) and nasal cavity volumes with acoustic rhinometry in 14 subjects before and after administration of vardenafil. Measurements were repeated after administration of a local decongestant spray.

RESULTS

There was no statistically significant difference between the nasal cavity volumes, MCA, and visual analog scale (VAS) scores before and after the administration of placebo. However, there was a significant increase in the nasal cavity volumes, MCAs, and VAS scores after application of the local decongestant. A significant correlation was found between MCAs and VAS scores (r = 0.96; p < 0.001). After administration of vardenafil, there was a significant increase in the degree of subjective sense of nasal obstruction as measured by VAS scores. Total nasal volumes showed a significant decrease (p < 0.05). The congestion effect induced by the vardenafil was reversed after application of the local decongestant spray, and a significant increase in cross-sectional areas was noted. In the vardenafil group, a significant increase in MCA, total volume, and VAS scores was observed after application of the local decongestant (p < 0.05).

CONCLUSION

Objective and subjective nasal obstruction after administration of vardenafil was significantly higher in this study than in previously reported studies. The effect of congestion can be reversed by local decongestants. The role of PDE5 inhibitors in nasal physiology merits additional investigation.