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Atorvastatin improves erectile dysfunction in patients initially irresponsive to Sildenafil by the activation of endothelial nitric oxide synthase

International Journal of Impotence Research volume 25, pages 143–148 (2013)Cite this article

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Abstract

This study aimed at comparing the effects of atorvastatin and vitamin E on erectile dysfunction in patients initially irresponsive to sildenafil, with investigation into the underlying possible mechanisms. Sixty patients were randomly divided into three groups: the atorvastatin group received 80 mg daily, the vitamin E group received 400 IU daily and the control group received placebo capsules. Patients were examined both before and after 6 weeks of treatment for biochemical tests; Superoxide dismutase (SOD), glutathione peroxidase (GPO), C-reactive protein (CRP), interleukin-6 (IL-6), nitric oxide (NO) and endothelial nitric oxide synthase (eNOS) and for erectile function tests; International index of erectile function (IIEF-5) scores and Rigiscan. Both atorvastatin and vitamin E showed a statistically significant GPO increase (P<0.05) and a statistically significant IL-6 decrease (P<0.05). Only atorvastatin showed a statistically significant increase in NO (15.19%, P<0.05), eNOS (20.58%, P<0.01), IIEF-5 score (53.1%, P<0.001) and Rigiscan rigidity parameters (P<0.01), in addition to a statistically significant decrease in CRP (57.9%, P<0.01). However, SOD showed a statistically significant increase only after vitamin E intake (23.1%, P<0.05). Both atorvatstain and vitamin E had antioxidant and anti-inflammatory activities. Although activating eNOS by atorvastatin was the real difference, and expected to be the main mechanism for NO increase and for improving erectile dysfunction. Atorvastatin, but not vitamin E, is a promising drug for sildenafil nonresponders.

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Acknowledgements

This work was supported and funded by Clinical Pharmacy Research Center in Faculty of Pharmacy, Tanta University. This center is a governmental research center that follows the ministry of Higher Education in Egypt. We thank the members of Urology Center, in Urology Department in Tanta University Hospital, and the members of Clinical Pharmacy Research Center, in Clinical Pharmacy Department in Faculty of Pharmacy, Tanta University.

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Authors and Affiliations

  1. Pharmacology Department, Professor of Pharmacology and Toxicology, Faculty of Pharmacy, Tanta University, Tanta, Egypt

    A A El-Sisi

  2. Clinical Pharmacy Department, Associate Professor of Clinical Pharmacy, Faculty of Pharmacy, Tanta University, Tanta, Egypt

    S K Hegazy

  3. Urology Department, Professor of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt

    K A Salem

  4. Clinical Pharmacy Department, M. Sc. of Clinical Pharmacy, Tanta University, Faculty of Pharmacy, Tanta University, Mahalla City, Egypt

    K S AbdElkawy

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  1. A A El-Sisi
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Correspondence to K S AbdElkawy.

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El-Sisi, A., Hegazy, S., Salem, K. et al. Atorvastatin improves erectile dysfunction in patients initially irresponsive to Sildenafil by the activation of endothelial nitric oxide synthase. Int J Impot Res 25, 143–148 (2013). https://doi.org/10.1038/ijir.2012.46

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