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Arthur L. Burnett, M.D., an excellent surgeon
and scientist, wants more for his radical
prostatectomy patients. “Even in the best of
surgical hands, the nerves coursing around
the prostate, which regulate penile erection,
can be traumatized during surgery,” he says.
Burnett has spent years in the laboratory as
well as the operating room, learning more
about how these extremely delicate nerves
are injured, and seeking new ways to protect
them.
Erectile dysfunction
after radical prostectomy
remains a major complication of the surgery
worldwide, he says. “Many men experience a delay
or incomplete
recovery of penile erection, even
when anatomical nerve-sparing radical
prostatectomy
is performed.” Burnett sought to address this problem by carrying
out a clinical trial investigating the potential benefit of an oral
drug that he helped develop.
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The
drug, called GPI1485, has the potential to protect nerves, and
help them recover their function more quickly after surgical trauma.
The trial was carried out between 2004 and 2006, and men were followed
up to a year afterward. About 200 patients from 22 clinical centers
participated in the study; men were randomly assigned either to
receive the drug or a placebo. In the final analysis, recovery
of erections after radical prostatectomy was similar for men who
took either the pills or the placebo every day for six months.
The treatment was well tolerated, and caused no major side effects.
Although Burnett had hoped for more dramatic results, he remains
hopeful. “This initial study, the first of its kind, did
not prove that the treatment was effective, but it did suggest
the feasibility of using ‘neuromodulatory’ drugs for
this purpose,” he says. “We remain extremely active
in this drug development research effort to facilitate the return
of erectile function following radical prostatectomy.” He
is now studying the ability of another promising drug, erythropoeitin,
to do this.
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