Examination of the Effects of Vardenafil on Esophageal Function Using Multichannel Intraluminal Impedance and Manometry

Abstract

Background/AimsTo evaluate the effects of the phosphodiesterase type 5 (PDE5) inhibitor vardenafil on esophageal function, including bolus transit, using multichannel intraluminal impedance and esophageal manometry (MII-EM).MethodsSixteen healthy volunteers (15 men) underwent an MII-EM study including 10 liquid swallows and 10 viscous swallows in a seated position after fasting. Then, each subject was asked to ingest 50 mL distilled water or 10 mg vardenafil dissolved in 50 mL water, in a double-blind manner. After 25 minutes, the MII-EM study was repeated.ResultsEight men received vardenafil and eight subjects received water. Resting and residual lower esophageal sphincter pressures differed significantly only in the vardenafil group (from 18 ± 6.7 to 6.6 ± 5.3 mmHg, P < 0.001 and from 4.9 ± 2.6 to 2.1 ± 3.6 mmHg, P = 0.006, respectively). Mean distal esophageal amplitude decreased significantly only in the vardenafil group (from 86.7 ± 41.6 to 34.0 ± 38.0 mmHg, P < 0.05). Complete bolus transits of liquid and viscous meals decreased significantly only after vardenafil ingestion (from 80.2% ± 13.8% to 49.4% ± 27.9%, P < 0.05 and from 72.8% ± 33.6% to 21.5% ± 29.0%, P = 0.01, respectively).ConclusionsVardenafil decreased esophageal bolus transit in the seated position, despite decreased lower esophageal sphincter pressure.

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

“…In the 14 included studies, two trials comprised healthy control subjects alongside patients with esophageal motility disorders [ 13 , 14 ], five studies conducted as a before/after trial on patients with esophageal motility disorders [ 16 , 18 , 20 , 22 , 25 ], and four trials conducted as RCT on healthy subjects [ 5 , 6 , 12 , 21 ]. Sildenafil was used in 11 studies [ 5 , 6 , 12 – 16 , 19 , 20 , 22 , 24 ]; one study only used vardenafil [ 21 ], and two studies only used tadalafil [ 18 , 25 ].…”

“…Nine studies have reported the LES pressure after using PDE-5 inhibitors in their manometry results [ 5 , 12 – 14 , 16 , 19 – 21 , 24 ]. The use of PDE-5 inhibitors was associated with a statistically significant reduction in the LES pressure (SMD − 1.69, 95% CI: -2.39 to -0.99) (Fig.…”

“…Four studies have reported the residual pressure of esophagus after using PDE-5 inhibitors in their manometry results [ 12 , 13 , 21 , 24 ]. There was no significant effect of PDE-5 inhibitors in reducing the residual pressure (SMD − 0.24, 95% CI: -1.20 to 0.72) (Fig.…”

“…Most of the evidence available from PDE-5 inhibitors are limited to sildenafil. Only 4 studies evaluated other PDE-5 inhibitors except sildenafil [ 11 , 18 , 21 , 25 ]. In the study by Rodriguez R. et al[ 25 ] 10 healthy volunteers and 10 patients with type II or III achalasia or hypertensive peristalsis were included and received 20 mg of tadalafil.…”

“…Moreover, the majority of patients did not have any signs of dysphagia after they were treated. In the vardenafil study by Lee et al[ 21 ] 16 healthy volunteers divided into distilled water or vardenafil group. The resting and residual pressure of LES were significantly differed only in the vardenafil group.…”