Evidence map›Paper›PMID 30150102›Full record

ArticleSexual medicine2018

Oral L-citrulline and Transresveratrol Supplementation Improves Erectile Function in Men With Phosphodiesterase 5 Inhibitors: A Randomized, Double-Blind, Placebo-Controlled Crossover Pilot Study.

Masato Shirai, Ippei Hiramatsu, Yusuke Aoki, Hirofumi Shimoyama, Taiki Mizuno, Taiji Nozaki, Shinichiro Fukuhara, Atsushi Iwasa, Shinji Kageyama, Akira Tsujimura

Open access · goldAbstract read
In one paragraph

Article in Sexual medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Masato ShiraiDepartment of Urology, Juntendo University Urayasu Hospital, Chiba, Japan.
Ippei HiramatsuDepartment of Urology, Juntendo University Urayasu Hospital, Chiba, Japan; Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan.
Yusuke AokiDepartment of Urology, Juntendo University Urayasu Hospital, Chiba, Japan; Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan.
Hirofumi ShimoyamaDepartment of Urology, Juntendo University Urayasu Hospital, Chiba, Japan; Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan.
Taiki MizunoDepartment of Urology, Juntendo University Urayasu Hospital, Chiba, Japan.
Taiji NozakiDepartment of Urology, Juntendo University Urayasu Hospital, Chiba, Japan.
Shinichiro FukuharaDepartment of Urology, Osaka University, Graduate School of Medicine, Osaka, Japan.
Atsushi IwasaIwasa Clinic, Osaka, Japan.
Shinji KageyamaKageyama Clinic, Shizuoka, Japan.
Akira TsujimuraDepartment of Urology, Juntendo University Urayasu Hospital, Chiba, Japan. Electronic address: atsujimu@juntendo.ac.jp.
Juntendo University Urayasu Hospital · JPJuntendo University · JPOsaka University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPhosphodiesterase type 5 inhibitors (PDE5i) are first-line therapy for most men with erectile dysfunction (ED). If ineffective, vacuum erection devices, intracavernous injections, and penile prosthesis implantation are suitable as second- or third-line therapies. However, very few patients select these therapies. It is critically important to improve erectile function with oral administration of effective agents. Administration of L-citrulline or transresveratrol in animal experiments has been reported to improve erectile function, but few such experiments have been performed on humans with ED.

aimWe aimed to investigate the efficacy of combination therapy of L-citrulline and transresveratrol in patients with ED despite their use of PDE5i.

methodsIn this randomized, double-blind, placebo-controlled crossover pilot study, men with ED (Sexual Health Inventory for Men [SHIM] score below 16) despite on-demand use of PDE5i received a placebo for 1 month or the active treatment (L-citrulline 800 mg/day and transresveratrol 300 mg/day) for another month. Patients continued on-demand use of PDE5i.

main outcome measureThe SHIM score, Erection Hardness Score (EHS), Aging Male Symptoms Scale-sexual domain (AMS-SD), and adverse events were examined.

results20 patients ages 29-78 years were enrolled, and after 6 men withdrew, 13 concluded the study without adverse events. Mean SHIM score for the active treatment increased significantly (10.96 ± 1.21) compared with baseline (8.32 ± 1.21) and placebo (8.31 ± 1.23) (both P < .05). Mean EHS score for the active treatment (2.56 ± 0.26) also increased from baseline (2.31 ± 0.26), but not significantly (P = .79). Mean AMS-SD score was not significantly different in either group.

conclusionTo our knowledge, this is the first study to show that combination therapy of L-citrulline and transresveratrol is effective for ED treatment in men with added on-demand use of PDE5i. This combination supplement may be added if PDE5i is insufficient. Shirai M, Hiramatsu I, Aoki Y, et al. Oral L-citrulline and Transresveratrol Supplementation Improves Erectile Function in Men With Phosphodiesterase 5 Inhibitors: A Randomized, Double-Blind, Placebo-Controlled Crossover Pilot Study. Sex Med 2018;6:291-296.

Indexed as

Erectile DysfunctionL-CitrullinePDE5iTransresveratrol

Identifiers

PMID30150102
PMCPMC6302103
OpenAlexW2888244220

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.