Boning Up on Tadalafil

La Belle Bianca Castafiore is driving me crazy. Indeed, I have Big-Bad Crazy-Ass Priapism -- and believe me, it lasts for more than four hours and occurs without the slightest hint of sexual stimulation. Oh, and what is it that stands so stoically erect? Only my last nerve... My precious, precious last nerve.

Translation in Webdings: La Belle Bianca Castafiore is driving me crazy. Indeed, I have Big-Bad Crazy-Ass Priapism -- believe me, it lasts for more than four hours and occurs without the slightest hint of sexual stimulation. Oh, and what is it that stands so stoically erect? Only my last nerve... My precious, precious last nerve.

Cough. Oh, right. Hello!

Perhaps some of you brainy types out there [*wave*] can tell me the critical standing of BMC journals; Specifically, whether their status is impacted by their liberal distribution policy:


Like all articles in BMC journals, this peer-reviewed article was published immediately upon acceptance. It can be downloaded, printed and distributed freely for any purposes (see copyright notice below). Articles in BMC journals are listed in PubMed and archived at PubMed Central.

As a non-scientist who nonetheless gamely works at comprehension, and as a petrified former scholar, I very much appreciate their policy.

Okay... first, excuse me while I play with fonts. Second, yes, Tadalafil is more widely known as Cialis. It's not too much of a stretch to pair the drug's effect on, umm, let's say, micro-vasculature -- with the want of dilation in cold CRPS. Right?





Here is the abstract of the article -- "Effect of tadalafil on blood flow, pain, and function in chronic cold Complex Regional Pain Syndrome: a randomized controlled trial" -- published in Musculoskeletal Disorders, 20 October 2008:

Background
This double-blind, randomized, controlled trial investigated the effect of the phosphodiesterase-5 inhibitor tadalafil on the microcirculation in patients with cold Complex Regional Pain Syndrome (CRPS) in one lower extremity.

Methods
Twenty-four patients received 20 mg tadalafil or placebo daily for 12 weeks. The patients also participated in a physical therapy program. The primary outcome measure was temperature difference between the CRPS side and the contralateral side, determined by measuring the skin temperature with videothermography. Secondary outcomes were: pain measured on a Visual Analogue Scale, muscle force measured with a MicroFet 2 dynamometer, and level of activity measured with an Activity Monitor (AM) and walking tests.

Results
At the end of the study period, the temperature asymmetry was not significantly reduced in the tadalafil group compared with the placebo group, but there was a significant and clinically relevant reduction of pain in the tadalafil group. Muscle force improved in both treatment groups and the AM revealed small, non-significant improvements in time spent standing, walking, and the number of short walking periods.

Conclusion
Tadalafil may be a promising new treatment for patients that have chronic cold CRPS due to endothelial dysfunction, and deserves further investigation. Trial Registration: The registration number in the Dutch Trial Register is ISRCTN60226869.


Authors: George Groeneweg , Frank JPM Huygen , Sjoerd P Niehof , Feikje Wesseldijk , Johannes BJ Bussmann , Fabienne C Schasfoort , Dirk L Stronks and Freek J Zijlstra