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Evidence and Clinical Data# Alprostadil Clinical Evidence# Alprostadil has the more extensive evidence base, reflecting three decades of clinical use: Intracavernosal efficacy response rates (defined as erection sufficient for intercourse) exceed 80% across diverse ED populations, including men with diabetes, cardiovascular disease, post-prostatectomy status, and spinal cord injury MUSE efficacy the intraurethral formulation shows lower response rates (approximately 43% successful intercourse) but provides a needle-free alternative PDE5 inhibitor failures alprostadil is effective in approximately 50-60% of men who do not respond to oral PDE5 inhibitors, making it the standard second-line therapy Long-term data studies with follow-up exceeding 5 years demonstrate sustained efficacy, though dropout rates of 30-50% reflect the burden of injection-based treatment Combination data alprostadil can be combined with PDE5 inhibitors or other vasoactive agents (papaverine, phentolamine in "trimix" formulations) for refractory cases PT-141 Clinical Evidence# PT-141's clinical data spans both female and male populations: RECONNECT trials (female) two Phase 3 pivotal trials in premenopausal women with HSDD showed statistically significant improvements in the Female Sexual Function Index desire domain and reductions in distress scores compared to placebo

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