Nerve-Protecting Drugs for Men After Radical Prostatectomy

Arthur L. Burnett.

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.

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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