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Biotech / Medical : VVUS: VIVUS INC. (NASDAQ)
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To: Edderd who wrote (7675)5/5/1998 10:15:00 AM
From: DaiS  Read Replies (3) of 23519
 
Ed,

It appears you are a physician - how well does muse really work? I looked at some abstracts that I could get hold of, but not those you mention for the forthcoming AUA meeting. My impression is that very roughly,

caverject: 50% hard erection with 80% sufficient for intercourse
muse: 10% hard erection with 50% sufficient for intercourse

but you say muse is 70% effective if used properly - does this mean that the silly joke about putting bait in the fishes mouth is not so silly after all? Is it possible that those studies reporting scientific results with a negative slant for muse are carried out by physicians who don't know how to (or don't want to!) teach the muse technique properly?

However it does seem to me from what evidence is available that injecting is much more efficient - which is not so surprising. It seems that the dose inserted in the penis with muse is 10x higher than that injected to be effective. Have you really heard that there is an M2 on the way with improved uptake of drug from urethra? Is the urethral burning pain reported caused by the high dose of alprostadil used? Why not recommend to users prone to pain that they take a painkiller or drink of alcohol before use? What about a bit of local anaesthetic squirted in the urethra. In general, do you know whether Vivus are attempting to research these problems.

Even though injection is efficient I read that it is not so popular (though the IMS sales figures for caverject are not that far behind muse). I heard that many men don't like injecting themselves, and their wives/partners don't like to do it for them. Also, is it true that the rapid erection achieved with injection is actually a turn off for wives - they feel they haven't caused it themselves? One defender of muse suggested that it was more a 'facilitator' giving that extra boost towards an erection sufficient for intercourse. Has there been switching from caverject to muse, then back again? Should we buy a few shares in Pharmacia or a few more in Vivus?

Dai
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