Phosphodiesterase 5 (PDE-5) inhibitors (sildenafil, tadalafil, and vardenafil) effects on esophageal motility: a systematic review

BMC Gastroenterology

Research

Arman Shafiee¹  Mohammad MobinTeymouri Athar²  Razman Arabzadeh Bahri³  Mostafa Gholami³  Fatemeh Afsharrezaei⁴ 

[1] Department of Psychiatry and Mental Health, Alborz University of Medical Sciences, Karaj, Iran;Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran;School of Medicine, Alborz University of Medical Sciences, Karaj, Iran;School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran;School of Medicine, Tehran University of Medical Sciences, Tehran, Iran;Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran;

关键词: Esophageal motility;    Achalasia;    Phosphodiesterase;    Sildenafil;    Tadalafil;    Vardenafil;   

DOI  :  10.1186/s12876-023-02787-3

 received in 2022-08-23, accepted in 2023-04-25,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundEsophageal motility disorders are a group of disorders associated with dysfunctional swallowing resulting from impaired neuromuscular coordination. Phosphodiesterase 5 (PDE-5) inhibitors induce smooth relaxation and are proposed as a treatment option for esophageal motility disorders such as achalasia.MethodsThis study is conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We systematically searched MEDLINE/ PubMed, Scopus, EMBASE, and Web of Science databases for esophageal outcomes of individuals treated with PDE5 inhibitors. A random effect meta-analysis was conducted.ResultsA total of 14 studies were included. They were conducted in different countries, with Korea and Italy having the highest number of articles. The main drug assessed was sildenafil. PDE-5 inhibitors resulted in a significant reduction in lower esophageal sphincter pressure (SMD − 1.69, 95% CI: -2.39 to -0.99) and the amplitude of contractions (SMD − 2.04, 95% CI: -2.97 to -1.11). Residual pressure was not significantly different between the placebo and sildenafil groups (SMD − 0.24, 95% CI: -1.20 to 0.72). Furthermore, a recent study reported contractile integral, stating that ingestion of sildenafil leads to a significant reduction in distal contractile integral and a significant increase in proximal contractile integral.ConclusionPDE-5 inhibitors significantly reduce LES resting pressure and esophageal peristaltic vigor, decreasing esophageal body contractility and contraction reserve. Therefore, using these drugs in patients affected by esophageal motility disorders may potentially improve their condition regarding symptom relief and prevention of further associated complications. Future reports investigating larger sample size is necessary in order to establish definite evidence regarding the efficacy of these drugs.

【 授权许可】

CC BY   
© The Author(s) 2023

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