Emerging drugs for the treatment of erectile dysfunction

Abstract

Introduction: Erectile dysfunction adversely affects the lives of millions of men, and is the most commonly treated sexual disorder today. The erectile process has been extensively investigated, with major advances made in elucidating many of the complex molecular pathways involved. These advances have allowed researchers to design and study drug formulations that target various aspects of this complex process. The initial culmination of this research was the introduction of phosphodiesterase 5-inhibitors. While effective in many patients, they are not satisfactory for all afflicted men. As a result, researchers are developing novel drugs that target different molecular pathways.

Areas covered: The paper will review these pathways, and the potential agents that target them. More specifically, first dopaminergic and melanocortin receptor agonists that act centrally will be covered. Then, the paper will examine the “second-generation” phosphodiesterase 5-inhibitors, soluble guanylate cyclases, rho-kinase inhibitors, and maxi-k channel activators that act peripherally.

Expert opinion: Most of these novel drugs have yet to reach Phase III studies. However, it is likely that in years to come, patients will be selectively treated with these novel agents as a monotherapy or in combination with others acting in a synergistic manner.

Keywords:

• clavulanic acid
• dopaminergic agonists
• erectile dysfunction
• intracavernosal injection therapy
• l-arginine
• lodenafil carbonate
• Maxi-K channel activators
• melanocortin receptor agonists
• mirodenafil
• phosphodiesterase-5 inhibitors
• Rho-kinase inhibitors
• sildenafil orodispersable tablet
• SLx-2101
• soluble guanylate cyclase
• udenafil
• yohimbine

Declaration of interest

W Hellstrom is a consultant or advisor to Abbvie, Allergan, American Medical Systems, Antares, Apricus, Astellas, Lilly, USA, Pfizer, Coloplast, Endo Pharmaceuticals, Promescent and Repros Therapeutics. He has acted as meeting participant or lecturer, consultant or advisor to Auxilium, as investigator for new Englnad Research Institutes, and is a board member, officer or trustee to the NIH amd Theralogix. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Notes