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Safety and Efficacy of Intracavernosal Injections of AbobotulinumtoxinA (Dysport®) as Add on Therapy to Phosphosdiesterase Type 5 Inhibitors or Prostaglandin E1 for Erectile Dysfunction-Case Studies.
Toxins (Basel) 2019; 11(5)T

Abstract

Erectile dysfunction (ED) is a highly prevalent condition with a variety of possible risk factors and/or etiologies. Despite significant advances regarding ED pharmacological management, there are still insufficient responders to existing pharmacological treatments e.g., approximately 30% of patients are insufficient responders to phosphodiesterase type 5 inhibitors (PDE5-Is). It has been recently proposed that botulinum toxin A intracavernosally (IC) delivered could be effective in these patients. Data from a retrospective uncontrolled single center study of 47 ED patients, consecutively recruited, insufficient responders to existing pharmacological treatments e.g., PDE5-Is or IC PGE1 injections treated with IC abobotulinumtoxinA 250 or 500 U as free combination with their existing treatment have been analyzed. Response rate, according to the International Index of Erectile Function-Erectile Function domain score, 6 weeks following IC abobotulinumtoxinA in combination with prior pharmacological treatment, was 54%. Two patients have reported mild penile pain on injection or during the 3 days following injection. Therapeutic efficacy did not seem to be influenced by the etiologies and/or risk factors for ED. Conversely, the less severe ED, the higher the response rate. Preliminary evidence for the therapeutical potential with acceptable safety of IC abobotulinumtoxinA as add-on therapy for ED not sufficiently responsive to standard therapy should be confirmed in randomized clinical trials.

Authors+Show Affiliations

Neuro-Uro-Andrology R.Poincare academic hospital, AP-HP, 104 bvd R. Poincare, 92380 Garches, France. francois.giuliano@uvsq.fr. Faculty of Medicine, Versailles Saint Quentin University, Paris Saclay, 78180 Montigny le Bretonneux, France. francois.giuliano@uvsq.fr.Neuro-Uro-Andrology R.Poincare academic hospital, AP-HP, 104 bvd R. Poincare, 92380 Garches, France. charles.joussain@uvsq.fr. Faculty of Medicine, Versailles Saint Quentin University, Paris Saclay, 78180 Montigny le Bretonneux, France. charles.joussain@uvsq.fr.Neuro-Uro-Andrology R.Poincare academic hospital, AP-HP, 104 bvd R. Poincare, 92380 Garches, France. pierre.denys@aphp.fr. Faculty of Medicine, Versailles Saint Quentin University, Paris Saclay, 78180 Montigny le Bretonneux, France. pierre.denys@aphp.fr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31117236

Citation

Giuliano, Francois, et al. "Safety and Efficacy of Intracavernosal Injections of AbobotulinumtoxinA (Dysport®) as Add On Therapy to Phosphosdiesterase Type 5 Inhibitors or Prostaglandin E1 for Erectile Dysfunction-Case Studies." Toxins, vol. 11, no. 5, 2019.
Giuliano F, Joussain C, Denys P. Safety and Efficacy of Intracavernosal Injections of AbobotulinumtoxinA (Dysport®) as Add on Therapy to Phosphosdiesterase Type 5 Inhibitors or Prostaglandin E1 for Erectile Dysfunction-Case Studies. Toxins (Basel). 2019;11(5).
Giuliano, F., Joussain, C., & Denys, P. (2019). Safety and Efficacy of Intracavernosal Injections of AbobotulinumtoxinA (Dysport®) as Add on Therapy to Phosphosdiesterase Type 5 Inhibitors or Prostaglandin E1 for Erectile Dysfunction-Case Studies. Toxins, 11(5), doi:10.3390/toxins11050283.
Giuliano F, Joussain C, Denys P. Safety and Efficacy of Intracavernosal Injections of AbobotulinumtoxinA (Dysport®) as Add On Therapy to Phosphosdiesterase Type 5 Inhibitors or Prostaglandin E1 for Erectile Dysfunction-Case Studies. Toxins (Basel). 2019 05 21;11(5) PubMed PMID: 31117236.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety and Efficacy of Intracavernosal Injections of AbobotulinumtoxinA (Dysport®) as Add on Therapy to Phosphosdiesterase Type 5 Inhibitors or Prostaglandin E1 for Erectile Dysfunction-Case Studies. AU - Giuliano,Francois, AU - Joussain,Charles, AU - Denys,Pierre, Y1 - 2019/05/21/ PY - 2019/04/22/received PY - 2019/05/13/revised PY - 2019/05/20/accepted PY - 2019/5/24/entrez PY - 2019/5/24/pubmed PY - 2019/5/24/medline KW - botulinum toxin A KW - combination therapy KW - mechanism of action KW - non-responders KW - pathophysiology KW - penile erection KW - pharmacology KW - sympathetic overactivity JF - Toxins JO - Toxins (Basel) VL - 11 IS - 5 N2 - Erectile dysfunction (ED) is a highly prevalent condition with a variety of possible risk factors and/or etiologies. Despite significant advances regarding ED pharmacological management, there are still insufficient responders to existing pharmacological treatments e.g., approximately 30% of patients are insufficient responders to phosphodiesterase type 5 inhibitors (PDE5-Is). It has been recently proposed that botulinum toxin A intracavernosally (IC) delivered could be effective in these patients. Data from a retrospective uncontrolled single center study of 47 ED patients, consecutively recruited, insufficient responders to existing pharmacological treatments e.g., PDE5-Is or IC PGE1 injections treated with IC abobotulinumtoxinA 250 or 500 U as free combination with their existing treatment have been analyzed. Response rate, according to the International Index of Erectile Function-Erectile Function domain score, 6 weeks following IC abobotulinumtoxinA in combination with prior pharmacological treatment, was 54%. Two patients have reported mild penile pain on injection or during the 3 days following injection. Therapeutic efficacy did not seem to be influenced by the etiologies and/or risk factors for ED. Conversely, the less severe ED, the higher the response rate. Preliminary evidence for the therapeutical potential with acceptable safety of IC abobotulinumtoxinA as add-on therapy for ED not sufficiently responsive to standard therapy should be confirmed in randomized clinical trials. SN - 2072-6651 UR - https://www.unboundmedicine.com/medline/citation/31117236/Safety_and_Efficacy_of_Intracavernosal_Injections_of_AbobotulinumtoxinA_(Dysport®)_as_Add_on_Therapy_to_Phosphosdiesterase_Type_5_Inhibitors_or_Prostaglandin_E1_for_Erectile_Dysfunction-Case_Studies L2 - http://www.mdpi.com/resolver?pii=toxins11050283 DB - PRIME DP - Unbound Medicine ER -