Apomorphine for the Treatment of Erectile Dysfunction: Systematic Review and Meta-Analysis
- PDF / 760,094 Bytes
- 17 Pages / 595.276 x 790.866 pts Page_size
- 77 Downloads / 174 Views
ORIGINAL PAPER
Apomorphine for the Treatment of Erectile Dysfunction: Systematic Review and Meta‑Analysis Virginia Guillén1 · José‑Ramón Rueda2 · Marta Lopez‑Argumedo3 · Ivan Solà4 · Javier Ballesteros1,5 Received: 3 April 2019 / Revised: 21 July 2020 / Accepted: 5 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Sublingual apomorphine could be an option in patients with erectile dysfunction who cannot take phosphodiesterase type 5 inhibitors (e.g., using nitrates). We have completed a systematic review to evaluate the effects of sublingual apomorphine comparing with placebo for treating erectile dysfunction. The evidence searching process finished on 9 January 2019. We included nine randomized controlled trials (RCTs). Treatment length varied from 4 to 8 weeks and doses ranged from 2 to 6 mg. The percent of successful sexual intercourse attempts per ingested dose of apomorphine was evaluated in eight studies. All the studies found that apomorphine was better than placebo (6–27% more successful intercourse attempts than with placebo), but differences were not statistically significant in one study done in patients previously treated with radical prostatectomy. Regarding erectile function scores, three studies reported higher improvement on the erectile function scores for apomorphine. Differences with placebo were not clinically relevant in another two studies, one in which only diabetic patients were included and one in which only patients with radical prostatectomy were involved. Discontinuation of treatment due to adverse events was higher for apomorphine, particularly for higher doses. Available evidence suggests that sublingual apomorphine is more effective than placebo, except for patients previously treated with radical prostatectomy, and is generally well tolerated at doses of 2 or 3 mg. Nowadays, sublingual apomorphine is the only licensed oral drug for erectile dysfunction not absolutely contraindicated with nitrates use, and more RCTs should be performed to evaluate its effects and safety for treating ED. Keywords Apomorphine · Erectile dysfunction · Randomized controlled trial (RCT) · DSM-5 · Meta-analysis
Introduction Erectile dysfunction (ED) is the inability to initiate or maintain a satisfactory erection for sexual intercourse (Brant, Lue, & Smith, 2009). ED is associated with depression, anxiety, and loss of self-esteem, and has a major impact on the quality * José‑Ramón Rueda [email protected] 1
Department of Neuroscience, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Spain
2
Department of Preventive Medicine and Public Health, Faculty of Medicine and Nursing, University of the Basque Country, 48080 Leioa, Spain
3
Department of Health, Osteba, Basque Office for Health Technology Assessment, Vitoria‑Gasteiz, Spain
4
Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau, CIBER Epidemiología y Salud Pública, Universitat Autònoma de Barcelona, Barcelona, Spain
5
CIBER Salud Mental, Madrid, S
Data Loading...
