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Title: DG DISPATCH - AUA: Apomorphine effectively treats erectile dysfunction due to coronary artery disease
URL: http://www.pslgroup.com/dg/1CFCD6.htm
Doctor's Guide
May 3, 2000


By Emma Patten
Special to DG News

ATLANTA, GA -- May 3, 2000 -- Apomorphine (Uprima) shows promise in the treatment of erectile dysfunction (ED) in patients with coronary artery disease (CAD), researchers report.

The study findings were presented Tuesday (May 2) at the American Urological Association's 95th Annual Meeting, in Atlanta, GA.

Eugene Dula, MD, a urologist with a private practice in Van Nuys, CA, and colleagues from TAP pharmaceuticals, the manufacturer of the Uprima, evaluated 1,472 patients randomized to four apomorphine doses - 2 mg, 4 mg, 5 mg or 6 mg.

Each of the groups was compared against a placebo group. Out of these patients, 224 (15 percent; mean age 59 years) had been diagnosed with CAD as evidenced by a history of angina, coronary artery bypass surgery, angioplasty, or myocardial infarction.

Among CAD patients, the percentage of attempts resulting in erections that were firm enough for intercourse were significantly larger in the apomorphine groups than in placebo group. These results were as follows: 41 percent with 2 mg versus 26 percent with placebo (p=0.003); 54 percent with 4 mg versus 25 percent with placebo (p<0.001); 48 percent for 5 mg versus 26 percent with placebo (p=0.011); 61 percent for 6 mg versus 41 percent with placebo.

Dr. Dula pointed out that the group is seeking approval for only 2 mg and 4 mg doses because of the adverse effects and minimal increase in benefit seen at higher doses.

"From a urologist's perspective, it is important to understand that this is an entirely novel agent and works totally differently from sildenafil (Viagra). It is a centrally-acting agent," Dr. Dula told Doctor's Guide.

According to Dr. Dula, apomorphine, which works by stimulating the dopamine receptors in the brain, can be used to treat ED in all associated conditions, not only CAD, but the group wanted to analyze the safety and efficacy of this drug specifically in this sub-population.

"Apomorphine works fairly quickly, in 20-25 minutes, and as early as 15 minutes. The main side effect is nausea-in about 15 percent of patients, but over time and repeated dosing, this effect rapidly dissipates," said Dr. Dula. "We think it is a safe and efficacious treatment for erectile dysfunction."

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