Is Sildenafil Safe In Cirrhosis Patients?

Main Category: Liver Disease / Hepatitis
Also Included In: Hypertension;  GastroIntestinal / Gastroenterology
Article Date: 13 Nov 2008 - 1:00 PST

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Sildenafil is valuable in the treatment of erectile dysfunction and pulmonary hypertension in patients with end-stage liver disease through inhibition of the type-5 phosphodiesterase. The type-5 phosphodiesterase is also present in human mesenteric arteries. The effect of sildenafil on splanchnic blood flow and portal hypertension remains essentially unknown.

The research team led by Otto Clemmesen from Denmark addresses this question and this was published in the World Journal of Gastroenterology.

Ten patients with biopsy proven cirrhosis (5 females/5 males, mean age 54 ± 8 years) and the hepatic venous pressure gradient (HVPG) above 12 mmHg were studied after informed consent. Measurement of splanchnic blood flow and the HVPG during liver vein catheterization were done before and 80 min after oral administration of 50 mg sildenafil. Blood flow was estimated by use of indocyanine green clearance technique and Fick's principle, with correction for non-steady state.

They found that the plasma concentration of sildenafil was 222 ± 136 ng/mL 80 min after administration. Mean arterial blood pressure decreased from 77 ± 7 to 66 ± 12 mmHg, P = 0.003, while the splanchnic blood flow and oxygen consumption remained unchanged at 1.1 ± 0.71 L/min and 2.3 ± 0.6 mmol/min, respectively. Also the HVPG remained unchanged (18 ± 2 vs 16 ± 2 mmHg) with individual changes ranging from -8 to +2 mmHg. In 7 patients HVPG decreased and in 3 it increased.

The result indicated that sildenafil do not induce any profound clinically relevant changes in splanchnic blood flow, oxygen consumption and HVPG in patients with cirrhosis. Phosphodiesterase type-5 inhibition is of no use as a therapeutic agent for alleviating portal hypertension in patients with chronic end-stage liver disease.

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Article adapted by Medical News Today from original press release.
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Reference: Clemmesen JO, Giraldi A, Ott P, Dalhoff K, Hansen BA, Larsen FS. Sildenafil does not influence hepatic venous pressure gradient in patients with cirrhosis. World J Gastroenterol 2008; 14(40): 6208-6212 http://www.wjgnet.com/1007-9327/14/6208.asp

Correspondence to: Jens Otto Clemmesen, MD, DMSc, Department of Hepatology A-2121, Rigshospitalet, Blegdamsvej 9, Copenhagen DK-2100, Denmark.

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

About The WJG Press

The WJG Press mainly publishes World Journal of Gastroenterology.

Source: Lai-Fu Li
World Journal of Gastroenterology