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MICHELE PROIETTI, ANTONIO AVERSA, CLAUDIO LETIZIA, CARMELINA ROSSI, GINEVRA MENGHI, ROBERTO BRUZZICHES, ARCANGELO MERLA, GIOVANNI SPERA, and FELICE SALSANO
ABSTRACT. Methods. In an open-label study, 14 nonconsecutive male patients with SSc with different degrees of ED were enrolled into the study irrespective of their clinical response to tadalafil, and received once-daily tadalafil 10 mg for 12 weeks. Primary endpoints were variations from baseline of penile arterial inflow [peak systolic velocity (PSV, cm/s); measured with dynamic color duplex ultrasound] and the erectile function domain score (measured with the International Index of Erectile Function questionnaire). Secondary endpoints were variations from baseline of morning erections (determined by modified question 13 of the Structured Interview on Erectile Dysfunction® questionnaire) and plasma concentrations of endothelin-1 (ET1). Results. The PSV and the erectile function domain score were significantly improved by once-daily tadalafil (from 21.3 ± 6.4 to 30.0 ± 7.0 cm/s and from 13.0 ± 6.8 to 17.0 ± 9.0 vs baseline, respectively; p < 0.05). Question 13 scores decreased dramatically after treatment compared with baseline (from 2.2 ± 0.2 to 0.8 ± 0.5 arbitrary units; p < 0.001), and plasma ET1 levels decreased (from 24 ± 15 to 9.8 ± 7.4 pg/ml; p < 0.05). Conclusion. In men with SSc-related ED, once-daily tadalafil improved both erectile function and vascular measures of cavernous arteries. Increases in morning erections and decreases in plasma ET1 levels were found, which may play a potential role in preventing progression of penile fibrosis and erectile dysfunction. (First Release July 1 2007; J Rheumatol 2007;34:1712-7) Key Indexing Terms:
ENDOTHELIUM
From the Department of Clinical Immunology and Allergy, Department of Medical Pathophysiology, and Department of Clinical Sciences, University of Rome "La Sapienza," Rome, and Department of Clinical Sciences and Bioimaging, University of Chieti, Chieti, Italy. M. Proietti, MD; C. Rossi, MD; G. Menghi, MD; F. Salsano, MD, Department of Clinical Immunology and Allergy; A. Aversa, MD, PhD; R. Bruzziches, MD; G. Spera, MD, Department of Medical Pathophysiology; C. Letizia, MD, Department of Clinical Sciences, University of Rome "La Sapienza"; A. Merla, PhD, Department of Clinical Sciences and Bioimaging, University of Chieti. Dr. Proietti and Dr. Aversa contributed equally to this report. Address reprint requests to Dr. M. Proietti, Department of Internal Medicine, University of Rome La Sapienza, Viale Policlinico 155, Rome 00161, Italy. E-mail: michele.proietti@tin.it Accepted for publication March 27, 2007. |
