Lipitor: Kick-start for Viagra?
Men with erectile dysfunction who do not experience symptom relief with Viagra (sildenafil) may have another option: A new study suggests Lipitor (atorvastatin) may improve men's response to Viagra.
The study included eight men with erectile dysfunction in whom Viagra initially appeared not to work. After taking daily doses of Lipitor for six weeks, these men found that Viagra worked better, according to researchers reported Howard C Herrmann, MD, of the Hospital of the University of Pennsylvania, and colleagues.
Results of the study were published in the March issue of the Journal of Sexual Medicine and summarized by MedPage Today on February 21, 2006.
The study results suggest that erectile dysfunction may be a sign of a generalized vascular disorder involving endothelial dysfunction, Dr Herrmann and colleagues said.
"We theorized that if you could make the endothelium healthier through use of statins - so that there is more nitric oxide available - you would improve the endothelial dysfunction and Viagra would work better for the patient," Dr Hermann reportedly said.
Clinical Trial
The pilot study included 12 men who did not respond to Viagra and had mildly elevated LDL cholesterol (>100 mg/dL; mean 58). Eight of these men were randomized to receive Lipitor 80 mg daily, and the other four received placebo. The researchers conducted follow-up at 6 and 12 weeks.
At 6 weeks, the mean erectile dysfunction score of the men receiving Lipitor had increased almost eight points on a 30-point scale, from 10 points (moderate to severe dysfunction) to 18 points (mild dysfunction). No significant increase occurred in the placebo group.
Adding to the encouraging results, all 8 men receiving Lipitor reported improved confidence in getting and keeping an erection, compared with just one man in the placebo group.
At 12 weeks, the average LDL cholesterol levels in the men receiving Lipitor had decreased 43% (135 mg/dL to 78 mg/dL). No significant increase occurred in the placebo group.
The researchers noted that no correlation existed between the amount by which LDL decreased and the amount of improvement of erectile dysfunction.
"The frequent coexistence of erectile dysfunction with coronary artery disease and cardiovascular risk factors may prompt further investigation of the lipid status in some patients with erectile dysfunction," the authors stated.
"Our study does not provide sufficient rationale for prescribing atorvastatin to patients with erectile dysfunction who do not have dyslipidemia, but it suggests that atherosclerotic risk factor modification could favorably improve erectile dysfunction in patients with or without hyperlipidemia.
"Our study strengthens this hypothesis and deserves further testing in a large clinical trial."
The study was supported by Pfizer, who manufacture both Viagra and Lipitor, according to MedPage Today, and. Dr Herrmann has received honoraria from Pfizer.
Sources: When Viagra Doesn't Work, Lipitor May Assist, MedPage Today, February 21, 2006. Can atorvastatin improve the response to sildenafil in men with erectile dysfunction not initially responsive to sildenafil? Hypothesis and pilot trial results. Herrmann HC et al, Journal of Sexual Medicine, volume 3, pages 303-308, 2006.
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