Dapagliflozin may improve erectile dysfunction among diabetes patients

The researchers revealed that patients treated with dapagliflozin plus tadalafil showed the greatest degree of improvement in erectile dysfunction, suggesting the dapagliflozin's ability to enhance the efficacy of tadalafil. This could have important implications for clinical practice.

Improvement in erectile dysfunction with dapagliflozin treatment was demonstrated by the increase in the International Index of Erectile Function 5-item questionnaire scores, and the improvement in the peak systolic velocity and the acceleration time in the cavernous arteries at dynamic penile echo colour Doppler ultrasound observed after treatment.

Erectile dysfunction is defined as the ability to maintain or achieve a rigid penile erection allowing for rewarding intercourse. It widely affects patients with type 2 diabetes mellitus. The role of dapagliflozin on erectile dysfunction has not yet been studied. Considering this, Rossella Cannarella, University of Catania, Catania, Italy, and colleagues aimed to evaluate the effects of dapagliflozin alone or in combination with tadalafil on ED in patients with T2D in an open-label, non-randomized pilot study.

The study included 30 Caucasian male patients with type 2 diabetes and severe erectile dysfunction. They were divided equally into three groups, Group 1; assigned to treatment with 5 mg/day tadalafil, Group 2; tadalafil 5 mg/day plus dapagliflozin 10 mg/day, and Group 3; dapagliflozin 10 mg/day for three months.

The presence and severity of ED were assessed at enrollment and after treatment by the dynamic penile echo colour Doppler ultrasound (PCDU) examination and the International Index of Erectile Function 5-item (IIEF-5) questionnaire.

The study led to the following findings:

• At the end of treatment, the three groups showed a significant improvement in IIEF-5 score, by 294%, 375% and 197%, in Groups 1, 2 and 3, respectively.
• PCDU evaluation showed a significant increase in peak systolic velocity by 178.9%, 339% and 153%; acceleration time was significantly shortened in Group 2 (−26.2%) and was significantly lower than in Group 1 and 3 (−7.2% and −6.6%), while no significant difference was found in end-diastolic velocity after treatment.
• The greatest rates of improvement were observed in Group 2 for all the endpoints.

"Our findings showed that dapagliflozin improves erectile dysfunction in patients with type 2 diabetes and enhances the efficacy of tadalafil," the researchers wrote. "There is a need for further studies to confirm our results and explain the mechanism(s) by which dapagliflozin exerts its effects on erectile dysfunction."

Reference:

Cannarella, R., Condorelli, R. A., Leanza, C., Garofalo, V., Aversa, A., Papa, G., Calogero, A. E., & Vignera, S. L. Dapagliflozin improves erectile dysfunction in patients with type 2 diabetes mellitus: An open-label, non-randomized pilot study. Diabetic Medicine, e15217. https://doi.org/10.1111/dme.15217