Recent studies suggest a potential link between the use of phosphodiesterase type 5 inhibitors (PDE5Is), commonly prescribed for erectile dysfunction (ED), and a reduced risk of Alzheimer's Disease (AD). This cohort study, with results published in Neurology, aimed to evaluate the association between PDE5I initiation and the risk of developing AD in men with ED.
Alzheimer's Disease (AD) is a prevalent form of dementia, necessitating ongoing research for preventive interventions. Repurposing existing drugs is a cost-effective strategy, and phosphodiesterase type 5 inhibitors (PDE5Is), initially developed for conditions like hypertension and erectile dysfunction, have shown promise in animal studies for AD risk reduction. However, evidence in humans remains inconclusive, prompting this cohort study to investigate the association between PDE5I initiation and AD risk in men with ED.
The study utilized IQVIA Medical Research Data UK electronic health records, identifying men aged ≥40 with new ED diagnoses between 2000 and 2017. Excluding individuals with dementia-related conditions, the cohort study employed Cox proportional hazard models to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). PDE5I initiation was associated with a lower risk of AD. The risk further decreased with >20 PDE5I prescriptions, suggesting a dose-dependent relationship.
The findings indicate that PDE5I initiation in men with ED is associated with a reduced risk of AD, particularly with more frequent prescriptions. However, the differences between primary and sensitivity analyses underscore the importance of exploring optimal lag periods. While previous studies presented conflicting results, this large cohort study contributes valuable insights, emphasizing the potential of PDE5Is in AD prevention. The call for a randomized controlled trial involving diverse populations and exploring various PDE5I doses aims to enhance the generalizability of these findings.
This cohort study strengthens the evidence suggesting that PDE5I initiation in men with ED is associated with a lower risk of AD, especially with increased prescription frequency. The study emphasizes the need for further research, including randomized trials, to confirm and generalize these findings. If validated, the repurposing of PDE5Is for AD prevention could represent a significant advancement in promoting healthy aging and addressing a critical need for preventive interventions in the face of a growing dementia burden.
Sources: Neurology