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Review of bosentan in the management of pulmonary arterial hypertension.

Gabbay E, Fraser J, McNeil K - Vasc Health Risk Manag (2007)

Bottom Line: Data is also presented on the potential benefit of bosentan in patients with inoperable chronic thromboembolic pulmonary hypertension.The safety and tolerability of bosentan as well as drug interactions are discussed.An algorithm is provided to guide the reader in monitoring potential increases in alanine and aspartate transaminase levels that may occur with bosentan use and the dose adjustments that are recommended as a result of any increase in the levels of these enzymes are shown.

View Article: PubMed Central - PubMed

Affiliation: Western Australian Lung Transplant Unit and Pulmonary Hypertension Service, Royal Perth Hospital, Western Australia, Australia. Eli.Gabbay@health.wa.gov.an

ABSTRACT
The dual endothelin receptor antagonist, bosentan, is an orally active therapy, which is effective in the treatment of pulmonary arterial hypertension (PAH). This review critically appraises the evidence for the efficacy of bosentan in idiopathic and familial PAH, in PAH associated with connective tissue disease and in PAH which may develop in association with other conditions. Data from the pivotal placebo controlled studies and their open labeled extensions as well as long term survival and quality of life data is presented. Data is also presented on the potential benefit of bosentan in patients with inoperable chronic thromboembolic pulmonary hypertension. The safety and tolerability of bosentan as well as drug interactions are discussed. Dosage recommendations in adults and pediatrics are presented. An algorithm is provided to guide the reader in monitoring potential increases in alanine and aspartate transaminase levels that may occur with bosentan use and the dose adjustments that are recommended as a result of any increase in the levels of these enzymes are shown. Finally, the role of bosentan as part of combination therapy in PAH is examined.

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Related in: MedlinePlus

Survival in adult patients with idiopathic pulmonary arterial hypertension treated with first line bosentan therapy compared to predicted survival with conventional therapy according to NIH registry. (Reproduced with permission from McLaughlin et al (2005)).
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fig2: Survival in adult patients with idiopathic pulmonary arterial hypertension treated with first line bosentan therapy compared to predicted survival with conventional therapy according to NIH registry. (Reproduced with permission from McLaughlin et al (2005)).

Mentions: The Kaplan-Meier survival estimate at two years was 89% in this study compared to the predicted two years survival (based on historical cohorts) of 57%. At each six month interval, observed survival was significantly better than predicted. Overall, patients receiving first line bosentan therapy had a 5.5% annual death rate (Figure 2).


Review of bosentan in the management of pulmonary arterial hypertension.

Gabbay E, Fraser J, McNeil K - Vasc Health Risk Manag (2007)

Survival in adult patients with idiopathic pulmonary arterial hypertension treated with first line bosentan therapy compared to predicted survival with conventional therapy according to NIH registry. (Reproduced with permission from McLaughlin et al (2005)).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2350123&req=5

fig2: Survival in adult patients with idiopathic pulmonary arterial hypertension treated with first line bosentan therapy compared to predicted survival with conventional therapy according to NIH registry. (Reproduced with permission from McLaughlin et al (2005)).
Mentions: The Kaplan-Meier survival estimate at two years was 89% in this study compared to the predicted two years survival (based on historical cohorts) of 57%. At each six month interval, observed survival was significantly better than predicted. Overall, patients receiving first line bosentan therapy had a 5.5% annual death rate (Figure 2).

Bottom Line: Data is also presented on the potential benefit of bosentan in patients with inoperable chronic thromboembolic pulmonary hypertension.The safety and tolerability of bosentan as well as drug interactions are discussed.An algorithm is provided to guide the reader in monitoring potential increases in alanine and aspartate transaminase levels that may occur with bosentan use and the dose adjustments that are recommended as a result of any increase in the levels of these enzymes are shown.

View Article: PubMed Central - PubMed

Affiliation: Western Australian Lung Transplant Unit and Pulmonary Hypertension Service, Royal Perth Hospital, Western Australia, Australia. Eli.Gabbay@health.wa.gov.an

ABSTRACT
The dual endothelin receptor antagonist, bosentan, is an orally active therapy, which is effective in the treatment of pulmonary arterial hypertension (PAH). This review critically appraises the evidence for the efficacy of bosentan in idiopathic and familial PAH, in PAH associated with connective tissue disease and in PAH which may develop in association with other conditions. Data from the pivotal placebo controlled studies and their open labeled extensions as well as long term survival and quality of life data is presented. Data is also presented on the potential benefit of bosentan in patients with inoperable chronic thromboembolic pulmonary hypertension. The safety and tolerability of bosentan as well as drug interactions are discussed. Dosage recommendations in adults and pediatrics are presented. An algorithm is provided to guide the reader in monitoring potential increases in alanine and aspartate transaminase levels that may occur with bosentan use and the dose adjustments that are recommended as a result of any increase in the levels of these enzymes are shown. Finally, the role of bosentan as part of combination therapy in PAH is examined.

Show MeSH
Related in: MedlinePlus