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Use of sildenafil (viagra) to alter fatigue, functional status and impaired cerebral blood flow in ... CFS, 2020, Friedman (Pfizer)

Discussion in 'BioMedical ME/CFS News' started by MEMarge, Dec 2, 2020.

  1. MEMarge

    MEMarge Senior Member (Voting Rights)

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    Last edited by a moderator: Dec 3, 2020
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  2. wigglethemouse

    wigglethemouse Senior Member (Voting Rights)

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  3. Hutan

    Hutan Moderator Staff Member

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    This study was double-blinded.

    Screen Shot 2020-12-03 at 6.31.45 PM.png

    It's a bit odd that the study was finished in 2010, but not written up until 2017.


    Screen Shot 2020-12-03 at 6.34.34 PM.png

    The reduction in fatigue could be significant e.g. an average reduction of 32 could mean that someone scoring most of the 42 questions as most severe (5 out of 5) at baseline could have improved so that most measures were only 4 out of 5.

    Screen Shot 2020-12-03 at 6.40.40 PM.png
    But that Primary Outcome Measure looks odd. The sildenafil was taken for 6 weeks, but it says the values are compared at 6 months. That seems unlikely to be correct.

    And the scoring looks odd too. 42 questions with a scoring range of 0,1,2,3,4. So the maximum score should be 168. But the study entry says the maximum is 148.

    So, it's hard to know what to make of this very small study. It would be interesting to hear from the researcher - was there any followup? And, if not, why not?
     
    Last edited: Dec 3, 2020
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  4. Hutan

    Hutan Moderator Staff Member

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    I emailed Professor Friedman, asking about the trial, including whether the blinding might not have worked, and he very kindly replied:

    Which is a shame.
     
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  5. alktipping

    alktipping Senior Member (Voting Rights)

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    i dislike the idea of hiding symptoms with medication because it is precisely those symptoms that warn us that we are coming very close to causing pem another catch 22 of this damned illness . i know from experience that just reading to much can and frequently does cause pem a dry mouth and sore throat tend to be my early warning signs.
     
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  6. Esther12

    Esther12 Senior Member (Voting Rights)

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    Thanks Hutan. And thanks to Friedman.
     
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  7. Barry

    Barry Senior Member (Voting Rights)

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    Hmmm ... :rolleyes:
     
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  8. Jaybee00

    Jaybee00 Senior Member (Voting Rights)

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    Looks promising— not sure why Pfizer didn’t follow up.
     
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  9. TiredSam

    TiredSam Moderator Staff Member

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    Oh Barry. I decided not to go there.
     
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  10. Barry

    Barry Senior Member (Voting Rights)

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    So did I ... but then changed my mind :)
     
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  11. Marky

    Marky Senior Member (Voting Rights)

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    Did you think someone would be to stiff for such jokes?:whistle:
     
  12. Diluted-biscuit

    Diluted-biscuit Senior Member (Voting Rights)

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    Wonder why recruitment was hard for this. It’s a commonly used drug and I assume relatively safe?
     
  13. Hutan

    Hutan Moderator Staff Member

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    Same. But, @Barry, you've made me do it. :) It actually was even better than that, Professor Friedman is an 'Endowed Professor'.
    Maybe the puerile jokes related to being a well-endowed professor studying viagra were part of why the study was more trouble than it was worth.
     
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  14. Hutan

    Hutan Moderator Staff Member

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    Seriously though, it is a shame the study couldn't be completed properly. I feel fairly sure that problems with blood circulation are part of the ME/CFS pathology.

    If the treatment can't be blinded, perhaps there could be some objective outcomes. Activity level might be one, although that would have to be measured for quite a long time to make sure it really was objective - which means treatment for a long time too. Measures of orthostatic intolerance perhaps would be more responsive.
     
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  15. Barry

    Barry Senior Member (Voting Rights)

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    That would not surprise me at all. Blood circulation, immune issues, food intolerances, allergies ... so many things feel like they could be clues, if only we knew what to make of them.
     
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  16. Barry

    Barry Senior Member (Voting Rights)

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    There are quite a lot of things I'd better refrain from saying in response to that :D.
     
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  17. Hutan

    Hutan Moderator Staff Member

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    Orthostatic intolerance = 'problems being upright'...
    A minefield of double entendre.
     
  18. TiredSam

    TiredSam Moderator Staff Member

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    Yes, I heard he was one of the university's most outstanding members.
     
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  19. TiredSam

    TiredSam Moderator Staff Member

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    I was told that people conducting such studies always went blind.
     
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  20. Tom Kindlon

    Tom Kindlon Senior Member (Voting Rights)

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    I know some people seem to get annoyed when I say this, but I think highlighting appeals for research subjects is something free that more people in the ME community could do to help support research.

    Researchers for ever reason don't seem to invest much time in it and rarely seem to spend any money on it.
     
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