Trial reportAlzheimer's & dementia : the journal of the Alzheimer's Association2022
The PASTIS trial: Testing tadalafil for possible use in vascular cognitive impairment.
Trial report in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Phosphodiesterase-5 inhibitors use and the risk of alzheimer's disease: a systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Pooled it
- Phosphodiesterase-5 inhibitors for cerebral small vessel disease-related ischemic stroke and cognitive decline: systematic review and meta-analysis.Frontiers in neurologyPooled it
- Neurovascular effects of tadalafil in patients with cerebral small vessel disease: ETLAS-2 substudy.Brain communications · 2026Trial
- Optimal markers of treatment response to vasodilatory drugs in small vessel disease: An OxHARP trial analysis.International journal of stroke : official journal of the International Stroke Society · 2026Trial
- Cerebrovascular Effects of Sildenafil in Small Vessel Disease: The OxHARP Trial.Circulation research · 2024Trial
- A pilot study to explore the effect of udenafil on cerebral hemodynamics in older adults.Annals of clinical and translational neurology · 2023Trial
- The PASTIS trial: Testing tadalafil for possible use in vascular cognitive impairment.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2022Trial
- CerebrAlcare Pills on CereBral Small VesseL DiseasE (CABLE) trial: rationale and design.Stroke and vascular neurology · 2026Article
- Proof-of-concept study: APOE4 brain endothelial cells as a phenotypic compound screen.Alzheimer's research & therapy · 2026Article
- Vascular cognitive impairment and dementia: Prevention, treatments, mechanisms and management options for the future.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Review
- Arterial spin labeling MRI in CADASIL: Implications for cerebral small vessel disease and therapeutic trials.Cerebral circulation - cognition and behavior · 2026Review
- Genetically Proxied Phosphodiesterase Type 5 (PDE5) Inhibition and Risk of Dementia: A Drug Target Mendelian Randomization Study.Molecular neurobiology · 2025Article
- Phosphodiesterase-5 Inhibitors and Dementia Risk: A Real-World Study.Neuroepidemiology · 2025Article
- Design of trials in lacunar stroke and cerebral small vessel disease: review and experience with the LACunar Intervention Trial 2 (LACI-2).Stroke and vascular neurology · 2024Review
- Article
- Cerebrovascular COJournal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2024Article
- The potential therapeutic effect of phosphodiesterase 5 inhibitors in the acute ischemic stroke (AIS).Molecular and cellular biochemistry · 2024Review
- Circadian and Diurnal Regulation of Cerebral Blood Flow.Circulation research · 2024Review
- Phosphodiesterase Type 5 Inhibitors in Men With Erectile Dysfunction and the Risk of Alzheimer Disease: A Cohort Study.Neurology · 2024Article
- A multicenter, single-arm, phase II clinical trial of adrenomedullin in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.Cerebral circulation - cognition and behavior · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
24 authors at 5 institutions in 3 countries.
Funding
Abstract
introductionThere are few randomized clinical trials in vascular cognitive impairment (VCI). This trial tested the hypothesis that the PDE5 inhibitor tadalafil, a widely used vasodilator, increases cerebral blood flow (CBF) in older people with symptomatic small vessel disease, the main cause of VCI.
methodsIn a double-blind, placebo-controlled, cross-over trial, participants received tadalafil (20 mg) and placebo on two visits ≥7 days apart (randomized to order of treatment). The primary endpoint, change in subcortical CBF, was measured by arterial spin labelling.
resultsTadalafil increased CBF non-significantly in all subcortical areas (N = 55, age: 66.8 (8.6) years) with greatest treatment effect within white matter hyperintensities (+9.8%, P = .0960). There were incidental treatment effects on systolic and diastolic blood pressure (-7.8, -4.9 mmHg; P < .001). No serious adverse events were observed. DISCUSSION: This trial did not identify a significant treatment effect of single-administration tadalafil on subcortical CBF. To detect treatment effects may require different dosing regimens.
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What OpenQuestion holds
Registered trials
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.