The PASTIS trial: Testing tadalafil for possible use in vascular cognitive impairment.

Autor:	Pauls MMH; Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK.; Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK., Binnie LR; Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK., Benjamin P; Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK.; Department of Neuroradiology, St George's University Hospitals NHS Foundation Trust, London, UK., Betteridge S; Department of Neuropsychology, St George's University Hospitals NHS Foundation Trust, London, UK., Clarke B; Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK., Dhillon MK; Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK., Ghatala R; South London Stroke Research Network, London, UK., Hainsworth FAH; Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK., Howe FA; Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK., Khan U; Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK., Kruuse C; Department of Neurology and Neurovascular Research Unit, Herlev Gentofte Hospital, Hellerup, Denmark., Madigan JB; Department of Neuroradiology, St George's University Hospitals NHS Foundation Trust, London, UK., Moynihan B; Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK.; Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland., Patel B; Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK., Pereira AC; Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK.; Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK., Rostrup E; Mental Health Centre, University of Copenhagen, Glostrup, Denmark., Shtaya ABY; Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK., Spilling CA; Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK., Trippier S; South London Stroke Research Network, London, UK., Williams R; South London Stroke Research Network, London, UK., Young R; Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK., Barrick TR; Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK., Isaacs JD; Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK.; Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK., Hainsworth AH; Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK.; Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK.
Jazyk:	angličtina
Zdroj:	Alzheimer's & dementia : the journal of the Alzheimer's Association [Alzheimers Dement] 2022 Dec; Vol. 18 (12), pp. 2393-2402. Date of Electronic Publication: 2022 Feb 08.
DOI:	10.1002/alz.12559
Abstrakt:	Introduction: There 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. Methods: In 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. Results: Tadalafil 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. (© 2022 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
Databáze:	MEDLINE
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