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Lower Doses of Bosentan in Combination With Sildenafil Might be Beneficial in Pulmonary Arterial Hypertension.

Amin A, Mohamadifar A, Taghavi S, Naderi N, Sadeghi H - Res Cardiovasc Med (2015)

Bottom Line: Endothelin-receptor-antagonist, bosentan, has been found to improve the functional capacity and cardiopulmonary hemodynamics in Pulmonary Arterial Hypertension (PAH).Clinical worsening occurred in six (14%) patients, at least one year after treatment, two of the cases failed to respond to 125 mg, twice daily and died.We observed acceptable results regarding both efficacy and safety with 62.5 mg of bosentan, twice daily in this group of patients.

View Article: PubMed Central - PubMed

Affiliation: Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

ABSTRACT

Background: Endothelin-receptor-antagonist, bosentan, has been found to improve the functional capacity and cardiopulmonary hemodynamics in Pulmonary Arterial Hypertension (PAH). Clinical trials have shown the preferable dosage of 125 mg, twice daily, regarding both efficacy and safety.

Objectives: The purpose of this study was to investigate the effects of lower doses of bosentan (62.5 mg, twice daily) in combination with sildenafil on exercise capacity and clinical events, in 41 patients with idiopathic pulmonary hypertension or chronic thromboembolic pulmonary hypertension (CTEPH).

Patients and methods: We assigned 41 patients with PAH (non-reactive idiopathic or non-operable chronic thromboembolic) to receive 62.5 mg of bosentan twice daily as combination therapy and evaluated the New York heart association (NYHA) functional class, 6-minutes-walk-distance (6MWD), time to clinical worsening, echocardiographic indexes and clinical events, for an average of 18.5 ± 9.5 months.

Results: No adverse drug reaction was observed during the follow-up. Clinical worsening occurred in six (14%) patients, at least one year after treatment, two of the cases failed to respond to 125 mg, twice daily and died. Eight (19%) remained in FC I_II, but didn't reach the goal of 380 meters for 6MWD. All other patients reached the treatment goals according to the latest European society of cardiology (ESC) guidelines.

Conclusions: We observed acceptable results regarding both efficacy and safety with 62.5 mg of bosentan, twice daily in this group of patients. Further clinical trials investigating PAH with lower dosages of bosentan may be warranted.

No MeSH data available.


Related in: MedlinePlus

Significant Improvement in Six-Minute Walking Distance (6MWD) During Follow-up
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fig21058: Significant Improvement in Six-Minute Walking Distance (6MWD) During Follow-up

Mentions: Improvements in 6MWD were observed in 36 patients, which were maintained till the end of the study. Baseline 6MWD was 330 ± 64 meters. After 18 months of treatment the walked distance increased to 390 ± 36 meters and this improvement was statistically significant (P = 0.01). Furthermore, 80% of patients reached the goal of 6MWD over 380 meters (Figure 1 and Table 2).


Lower Doses of Bosentan in Combination With Sildenafil Might be Beneficial in Pulmonary Arterial Hypertension.

Amin A, Mohamadifar A, Taghavi S, Naderi N, Sadeghi H - Res Cardiovasc Med (2015)

Significant Improvement in Six-Minute Walking Distance (6MWD) During Follow-up
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4588707&req=5

fig21058: Significant Improvement in Six-Minute Walking Distance (6MWD) During Follow-up
Mentions: Improvements in 6MWD were observed in 36 patients, which were maintained till the end of the study. Baseline 6MWD was 330 ± 64 meters. After 18 months of treatment the walked distance increased to 390 ± 36 meters and this improvement was statistically significant (P = 0.01). Furthermore, 80% of patients reached the goal of 6MWD over 380 meters (Figure 1 and Table 2).

Bottom Line: Endothelin-receptor-antagonist, bosentan, has been found to improve the functional capacity and cardiopulmonary hemodynamics in Pulmonary Arterial Hypertension (PAH).Clinical worsening occurred in six (14%) patients, at least one year after treatment, two of the cases failed to respond to 125 mg, twice daily and died.We observed acceptable results regarding both efficacy and safety with 62.5 mg of bosentan, twice daily in this group of patients.

View Article: PubMed Central - PubMed

Affiliation: Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

ABSTRACT

Background: Endothelin-receptor-antagonist, bosentan, has been found to improve the functional capacity and cardiopulmonary hemodynamics in Pulmonary Arterial Hypertension (PAH). Clinical trials have shown the preferable dosage of 125 mg, twice daily, regarding both efficacy and safety.

Objectives: The purpose of this study was to investigate the effects of lower doses of bosentan (62.5 mg, twice daily) in combination with sildenafil on exercise capacity and clinical events, in 41 patients with idiopathic pulmonary hypertension or chronic thromboembolic pulmonary hypertension (CTEPH).

Patients and methods: We assigned 41 patients with PAH (non-reactive idiopathic or non-operable chronic thromboembolic) to receive 62.5 mg of bosentan twice daily as combination therapy and evaluated the New York heart association (NYHA) functional class, 6-minutes-walk-distance (6MWD), time to clinical worsening, echocardiographic indexes and clinical events, for an average of 18.5 ± 9.5 months.

Results: No adverse drug reaction was observed during the follow-up. Clinical worsening occurred in six (14%) patients, at least one year after treatment, two of the cases failed to respond to 125 mg, twice daily and died. Eight (19%) remained in FC I_II, but didn't reach the goal of 380 meters for 6MWD. All other patients reached the treatment goals according to the latest European society of cardiology (ESC) guidelines.

Conclusions: We observed acceptable results regarding both efficacy and safety with 62.5 mg of bosentan, twice daily in this group of patients. Further clinical trials investigating PAH with lower dosages of bosentan may be warranted.

No MeSH data available.


Related in: MedlinePlus