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ABSTRACT The management of erectile dysfunction (ED) has been revolutionized by the discovery of phosphodiesterase 5 (PDE5) inhibitors, which have been commercially available for more than a

decade and are the first-line therapeutic option for men with ED. Sildenafil, vardenafil and tadalafil were approved by the European Medicine Agency and the US FDA for the treatment of ED

on the back of their high efficacy rates and favorable safety profiles. However, despite the fact that more than 50 million patients with ED worldwide have been successfully treated with one

of these PDE5 inhibitors, some men—most notably those with severe neurologic damage, diabetes mellitus or severe vascular disease—are resistant to the currently available drugs and require

more-invasive treatments, such as intracavernosal injection therapy. Partly as a consequence of this, research into alternative therapeutic approaches continues, including the development of

new PDE5 inhibitors, centrally acting pharmaceutical agents, and application of molecular technologies such as gene therapy and stem cell therapy. KEY POINTS * Phosphodiesterase type 5

(PDE5) inhibitors remain the first-line therapy for most men with erectile dysfunction (ED) * The currently available PDE5 inhibitors (sildenafil, vardenafil and tadalafil) are all highly

effective and well tolerated * New PDE5 inhibitors under clinical development differ from established agents mainly in terms of their pharmacokinetics, and possibly in relation to their

selectivity * Other approaches to the treatment of ED include the use of centrally acting agents, gene therapy and stem cell therapy; such approaches are currently some way away from

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our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS MIRABEGRON IMPROVES ERECTILE FUNCTION IN MEN WITH OVERACTIVE BLADDER AND ERECTILE DYSFUNCTION: A 12-WEEK PILOT

STUDY Article 02 July 2021 PHOSPHODIESTERASE TYPE 5 INHIBITORS DO NOT PREVENT CURVATURE PROGRESSION BUT SHORTEN PAIN DURATION IN THE ACTIVE PHASE OF PEYRONIE’S DISEASE: A RETROSPECTIVE

COHORT STUDY Article Open access 16 January 2024 COMBINATION THERAPY WITH TOPICAL ALPROSTADIL AND PHOSPHODIESTERASE-5 INHIBITORS AFTER FAILURE OF ORAL THERAPY IN PATIENTS WITH ERECTILE

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Article  CAS  PubMed  Google Scholar  Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * University Hospital of North Tees, Hardwick Road, Stockton-on-Tees, Cleveland, TS19

8PE, UK Victor Palit * Pyrah Department of Urology, St James University Hospital, Beckett Street, Leeds, LS9 7TF, West Yorkshire, UK Ian Eardley Authors * Victor Palit View author

publications You can also search for this author inPubMed Google Scholar * Ian Eardley View author publications You can also search for this author inPubMed Google Scholar CONTRIBUTIONS Both

authors contributed equally to researching data for the article, discussing the content, writing, and review/editing of the manuscript before submission. CORRESPONDING AUTHOR Correspondence

to Ian Eardley. ETHICS DECLARATIONS COMPETING INTERESTS I. Eardley has acted as a consultant for Eli Lilly and Company and Bayer Schering Pharma, and has received speakers' bureau

(honoraria) and grant-research support from Pfizer, Eli Lilly and Company and Bayer Schering Pharma. V. Palit declares no competing interests. RIGHTS AND PERMISSIONS Reprints and permissions

ABOUT THIS ARTICLE CITE THIS ARTICLE Palit, V., Eardley, I. An update on new oral PDE5 inhibitors for the treatment of erectile dysfunction. _Nat Rev Urol_ 7, 603–609 (2010).

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