Scoping review exploring advancements in topical agent therapies for erectile dysfunction

Area of Science:

• Urology
• Pharmacology
• Dermatology

Background:

• Erectile dysfunction (ED) is prevalent in older men, often linked to comorbidities.
• Oral phosphodiesterase 5 inhibitors are standard ED treatments but have limitations and contraindications.
• Topical gels are emerging as alternative pharmacologic treatments for ED.

Purpose of the Study:

• To review the efficacy and safety of topical agents for treating ED.
• To assess the effectiveness of transdermal delivery systems for ED pharmacotherapy.

Main Methods:

• Searched PubMed, Cochrane, Embase, and Web of Science databases.
• Included randomized controlled trials investigating topical agents applied to the penis for ED.
• Focused on studies evaluating treatment effectiveness and patient outcomes.

Main Results:

• Topical alprostadil, glyceryl trinitrate (MED2005), and MED3000 were evaluated in 7 articles with 3475 patients.
• Topical alprostadil achieved erections in 67-75% of patients, significantly improving International Index of Erectile Function scores.
• MED2005 showed rapid action (70% effectiveness within 10 minutes), and MED3000 improved erectile function domain scores by 5.73 points over 24 weeks.
• Topical ED therapies demonstrated acceptable safety profiles.

Conclusions:

• Topical agents are effective, well-tolerated treatments for ED, offering various mechanisms of action.
• A fast-acting topical agent with reduced side effects has been identified.
• Topical therapies provide a viable alternative for patients who cannot use oral phosphodiesterase 5 inhibitors, though direct comparison to first-line treatments is pending.