PDF(Pubmed)
Abstract：
Phosphodiesterase-5 inhibitors (PDE5i) have been evaluated as a novel treatment for Alzheimer\'s disease and related dementias (ADRD), but two recent cohort studies have offered opposing conclusions.
We performed an unmatched case-control study using electronic medical records from a large healthcare system to evaluate the association of PDE5i use and ADRD in patients ≥65 years old.
Odds of PDE5i exposure were 64.2%, 55.7%, and 54.0% lower in patients with ADRD than controls among populations with erectile dysfunction, benign prostatic hyperplasia, and pulmonary hypertension, respectively. We observed odds ratios less than unity among males and females and with exposure to the PDE5i sildenafil (Viagra®) and tadalafil (Cialis®). We also evaluated the odds of exposure to two other common treatments for pulmonary hypertension: endothelin receptor antagonists (ERA) and calcium channel blockers (CCB). The odds of ERA exposure were 63.2% lower, but the odds of CCB exposure were 30.7% higher, in patients with ADRD than controls among the population with pulmonary hypertension.
Our results reconcile the opposing conclusions from the previous observational studies and support further research into using PDE5i for prevention and treatment of ADRD.
We performed an unmatched case-control study using electronic medical records from a large healthcare system to evaluate the association of PDE5i use and ADRD in patients ≥65 years old.
Odds of PDE5i exposure were 64.2%, 55.7%, and 54.0% lower in patients with ADRD than controls among populations with erectile dysfunction, benign prostatic hyperplasia, and pulmonary hypertension, respectively. We observed odds ratios less than unity among males and females and with exposure to the PDE5i sildenafil (Viagra®) and tadalafil (Cialis®). We also evaluated the odds of exposure to two other common treatments for pulmonary hypertension: endothelin receptor antagonists (ERA) and calcium channel blockers (CCB). The odds of ERA exposure were 63.2% lower, but the odds of CCB exposure were 30.7% higher, in patients with ADRD than controls among the population with pulmonary hypertension.
Our results reconcile the opposing conclusions from the previous observational studies and support further research into using PDE5i for prevention and treatment of ADRD.
摘要：
背景：磷酸二酯酶-5抑制剂（PDE5i）已被评估为阿尔茨海默病和相关痴呆（ADRD）的新型治疗方法，但是最近的两项队列研究得出了相反的结论。
方法：我们使用来自大型医疗保健系统的电子病历进行了一项不匹配的病例对照研究，以评估≥65岁患者PDE5i使用与ADRD的相关性。
结果：PDE5i暴露的几率为64.2%，55.7%,ADRD患者的勃起功能障碍患者比对照组低54.0%，良性前列腺增生,肺动脉高压,分别。我们观察到男性和女性以及暴露于PDE5i西地那非（伟哥®）和他达拉非（Cialis®）的比值比小于统一。我们还评估了暴露于其他两种常见的肺动脉高压治疗方法的几率：内皮素受体拮抗剂（ERA）和钙通道阻滞剂（CCB）。ERA暴露的几率降低了63.2%，但是建行风险敞口的几率高出30.7%，ADRD患者高于肺动脉高压人群中的对照组。
结论：我们的结果与先前观察性研究的相反结论相一致，并支持使用PDE5i预防和治疗ADRD的进一步研究。
方法：我们使用来自大型医疗保健系统的电子病历进行了一项不匹配的病例对照研究，以评估≥65岁患者PDE5i使用与ADRD的相关性。
结果：PDE5i暴露的几率为64.2%，55.7%,ADRD患者的勃起功能障碍患者比对照组低54.0%，良性前列腺增生,肺动脉高压,分别。我们观察到男性和女性以及暴露于PDE5i西地那非（伟哥®）和他达拉非（Cialis®）的比值比小于统一。我们还评估了暴露于其他两种常见的肺动脉高压治疗方法的几率：内皮素受体拮抗剂（ERA）和钙通道阻滞剂（CCB）。ERA暴露的几率降低了63.2%，但是建行风险敞口的几率高出30.7%，ADRD患者高于肺动脉高压人群中的对照组。
结论：我们的结果与先前观察性研究的相反结论相一致，并支持使用PDE5i预防和治疗ADRD的进一步研究。
