Combination therapy with topical alprostadil and phosphodiesterase-5 inhibitors after failure of oral therapy in patients with erectile dysfunction: a prospective, two-arm, open-label, non-randomized study was written by Garrido-Abad, Pablo;Senra-Bravo, Isabel;Manfredi, Celeste;Fernandez-Pascual, Esau;Linares-Espinos, Estefania;Fernandez-Arjona, Manuel;Varillas-Delgado, David;Martinez-Salamanca, Juan Ignacio. And the article was included in International Journal of Impotence Research in 2022.Synthetic Route of C23H32N6O4S This article mentions the following:
Abstract: To evaluate efficacy and safety of combination therapy with PDE5I and topical alprostadil in patients with ED non-responders to PDE5I alone. Patients over 18 years old, with stable sexual relationship for at least 6 mo, and ED non-responders to PDE5I monotherapy were included in study. At baseline the variables assessed were 5-item version of International Index of Erectile Function (IIEF-5), and Sexual Encounter Profile Questions 2 and 3 (SEP-2 and SEP-3). All patients were assigned to monotherapy group (Group A) or combination therapy group (Group B) based on their preference. 52 patients were previously treated with sildenafil 100 mg (30.6%), 6 with vardenafil 20 mg (3.5%), 56 with tadalafil 20 mg (32.9%), and 56 with avanafil 200 mg (32.9%). Mean IIEF-5 score increased significantly in Group B after treatment compared to baseline, conversely patients in Group A showed no increase. Number of affirmative responses to SEP-2 was higher after treatment compared to baseline only in Group B. Number of affirmative responses to SEP-3 was higher after treatment compared to baseline in both groups (p < 0.001). Number of affirmative responses to GAQ-Q1 and GAQ-Q2 was significantly higher in Group B compared to Group A (p < 0.001). A total of 59 (34.7%) patients experienced AEs. No episode of priapism was recorded. Combination therapy with topical alprostadil and PDE5I seems to be more effective than topical alprostadil alone without worsening safety of the treatment. In the experiment, the researchers used many compounds, for example, 2-(2-Ethoxy-5-((4-ethylpiperazin-1-yl)sulfonyl)phenyl)-5-methyl-7-propylimidazo[5,1-f][1,2,4]triazin-4(3H)-one (cas: 224785-90-4Synthetic Route of C23H32N6O4S).
2-(2-Ethoxy-5-((4-ethylpiperazin-1-yl)sulfonyl)phenyl)-5-methyl-7-propylimidazo[5,1-f][1,2,4]triazin-4(3H)-one (cas: 224785-90-4) belongs to piperazine derivatives. A form in which piperazine is commonly available industrially is as the hexahydrate, C4H10N2. 6H2O, which melts at 44 °C and boils at 125–130 °C. Piperazine is an anthelminthic especially useful in the treatment of partial intestinal obstruction caused by Ascaris worms, which is a condition primarily seen in children. Piperazine hydrate and piperazine citrate are the main anthelminthic piperazines.Synthetic Route of C23H32N6O4S
Referemce:
Piperazine – Wikipedia,
Piperazines – an overview | ScienceDirect Topics