| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Hannover Medical School, Hannover, Germany
CORRESPONDENCE: M.M. Hoeper, Dept of Respiratory Medicine, Hannover Medical School, 30623 Hannover, Germany. Fax: 49 5115328536. E-mail: hoeper.marius@mh-hannover.de
Keywords: cardiopulmonary exercise testing, endothelin-receptor antagonists, prostaglandins, pulmonary hypertension
Received: January 23, 2003
Accepted February 14, 2003
Primary pulmonary hypertension (PPH) is a life-threatening disease. Nonparenteral prostanoids, i.e. aerosolised iloprost or oral beraprost sodium show beneficial therapeutic effects but are not sufficiently active in all patients with this devastating disease. The purpose of the present study was to determine whether the endothelin-receptor antagonist bosentan is safe and effective in patients with PPH already receiving nonparenteral prostanoids.
The effect of bosentan as add-on medication was studied in 20 patients with PPH, who received either inhaled iloprost (n=9) or oral beraprost (n=11) for a median period of 16±13 months, by means of the 6-min walk test and cardiopulmonary exercise testing.
After 3 months of administration of bosentan in addition to prostanoids, the walking distance in the 6-min walk test increased by 58±43 m. Cardiopulmonary exercise testing revealed an increase in maximal oxygen consumption from 11.0±2.3 to 13.8±3.6 mL·kg–1·min–1 accompanied by significant improvements in anaerobic threshold, oxygen pulse and minute ventilation/carbon dioxide production slope. Peak systolic blood pressure increased from 120±17 to 139±21 mmHg. Combination treatment was well tolerated by all patients.
It is concluded that the addition of the endothelin-receptor antagonist bosentan to inhaled iloprost or oral beraprost therapy appears to be safe for patients with primary pulmonary hypertension, resulting in a marked increase in exercise capacity. Therefore, rigorous studies should address whether combination treatment is more effective than either therapeutic intervention alone.
This article has been cited by other articles:
|
|
 |
|
  K. Boutet, D. Montani, X. Jais, A. Yaici, O. Sitbon, G. Simonneau, and M. Humbert Review: Therapeutic advances in pulmonary arterial hypertension Therapeutic Advances in Respiratory Disease, August 1, 2008; 2(4): 249 - 265. [Abstract] [PDF]
|
|
|
|
 |
|
 R. L. Benza, B. K. Rayburn, J. A. Tallaj, S. V. Pamboukian, and R. C. Bourge Treprostinil-Based Therapy in the Treatment of Moderate-to-Severe Pulmonary Arterial Hypertension: Long-term Efficacy and Combination With Bosentan Chest, July 1, 2008; 134(1): 139 - 145. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Gomberg-Maitland and H. Olschewski Prostacyclin therapies for the treatment of pulmonary arterial hypertension Eur. Respir. J., April 1, 2008; 31(4): 891 - 901. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Dupuis and M. M. Hoeper Endothelin receptor antagonists in pulmonary arterial hypertension Eur. Respir. J., February 1, 2008; 31(2): 407 - 415. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Takaoka, J. L. Faul, and R. Doyle Current Therapies for Pulmonary Arterial Hypertension Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2007; 11(2): 137 - 148. [Abstract] [PDF]
|
|
|
|
|
|
M. M. Hoeper, M. W. Pletz, H. Golpon, and T. Welte Prognostic value of blood gas analyses in patients with idiopathic pulmonary arterial hypertension Eur. Respir. J., May 1, 2007; 29(5): 944 - 950. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. V. McLaughlin, R. J. Oudiz, A. Frost, V. F. Tapson, S. Murali, R. N. Channick, D. B. Badesch, R. J. Barst, H. H. Hsu, and L. J. Rubin Randomized Study of Adding Inhaled Iloprost to Existing Bosentan in Pulmonary Arterial Hypertension Am. J. Respir. Crit. Care Med., December 1, 2006; 174(11): 1257 - 1263. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. N. Channick, H. Olschewski, W. Seeger, T. Staub, R. Voswinckel, and L. J. Rubin Safety and Efficacy of Inhaled Treprostinil as Add-On Therapy to Bosentan in Pulmonary Arterial Hypertension J. Am. Coll. Cardiol., October 3, 2006; 48(7): 1433 - 1437. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Mereles, N. Ehlken, S. Kreuscher, S. Ghofrani, M. M. Hoeper, M. Halank, F. J. Meyer, G. Karger, J. Buss, J. Juenger, et al. Exercise and Respiratory Training Improve Exercise Capacity and Quality of Life in Patients With Severe Chronic Pulmonary Hypertension Circulation, October 3, 2006; 114(14): 1482 - 1489. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Gomberg-Maitland Learning to pair therapies and the expanding matrix for pulmonary arterial hypertension: is more better? Eur. Respir. J., October 1, 2006; 28(4): 683 - 686. [Full Text] [PDF]
|
|
|
|
|
|
M. M. Hoeper, H. Leuchte, M. Halank, H. Wilkens, F. J. Meyer, H. J. Seyfarth, R. Wensel, F. Ripken, H. Bremer, S. Kluge, et al. Combining inhaled iloprost with bosentan in patients with idiopathic pulmonary arterial hypertension Eur. Respir. J., October 1, 2006; 28(4): 691 - 694. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. A. Ghofrani, R. Voswinckel, F. Reichenberger, N. Weissmann, R. T. Schermuly, W. Seeger, and F. Grimminger Hypoxia- and non-hypoxia-related pulmonary hypertension - Established and new therapies Cardiovasc Res, October 1, 2006; 72(1): 30 - 40. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Distler and A. Pignone Pulmonary arterial hypertension and rheumatic diseases--from diagnosis to treatment Rheumatology, October 1, 2006; 45(suppl_4): iv22 - iv25. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Provencher, X. Jais, A. Yaici, O. Sitbon, M. Humbert, and G. Simonneau Clinical Challenges in Pulmonary Hypertension: Roger S. Mitchell Lecture Chest, December 1, 2005; 128(6_suppl): 622S - 628S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Provencher, X. Jais, A. Yaici, O. Sitbon, M. Humbert, and G. Simonneau Clinical Challenges in Pulmonary Hypertension: Roger S. Mitchell Lecture Chest, December 1, 2005; 128(6_suppl): 622S - 628S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. F. Opitz, R. Wensel, J. Winkler, M. Halank, L. Bruch, F.-X. Kleber, G. Hoffken, S. D. Anker, A. Negassa, S. B. Felix, et al. Clinical efficacy and survival with first-line inhaled iloprost therapy in patients with idiopathic pulmonary arterial hypertension Eur. Heart J., September 2, 2005; 26(18): 1895 - 1902. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. J. Rubin and D. B. Badesch Evaluation and Management of the Patient with Pulmonary Arterial Hypertension Ann Intern Med, August 16, 2005; 143(4): 282 - 292. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-J. Seyfarth, H. Pankau, S. Hammerschmidt, J. Schauer, H. Wirtz, and J. Winkler Bosentan Improves Exercise Tolerance and Tei Index in Patients With Pulmonary Hypertension and Prostanoid Therapy Chest, August 1, 2005; 128(2): 709 - 713. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. E Baker and R. H. Hockman Inhaled Iloprost in Pulmonary Arterial Hypertension Ann. Pharmacother., July 1, 2005; 39(7): 1265 - 1274. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. M. Hoeper, M. Halank, C. Marx, G. Hoeffken, H. J. Seyfarth, J. Schauer, J. Niedermeyer, and J. Winkler Bosentan therapy for portopulmonary hypertension Eur. Respir. J., March 1, 2005; 25(3): 502 - 508. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. M. Novick, N. Sandoval, V. V. Lazorhysynets, V. Castillo, A. Baskevitch, X. Mo, R. W. Reid, B. Marinovic, and T. G. Di Sessa Flap Valve Double Patch Closure of Ventricular Septal Defects in Children With Increased Pulmonary Vascular Resistance Ann. Thorac. Surg., January 1, 2005; 79(1): 21 - 28. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.M. Hoeper, C. Faulenbach, H. Golpon, J. Winkler, T. Welte, and J. Niedermeyer Combination therapy with bosentan and sildenafil in idiopathic pulmonary arterial hypertension Eur. Respir. J., December 1, 2004; 24(6): 1007 - 1010. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Humbert, O. Sitbon, and G. Simonneau Treatment of Pulmonary Arterial Hypertension N. Engl. J. Med., September 30, 2004; 351(14): 1425 - 1436. [Full Text] [PDF]
|
|
|
|
|
|
M.M. Hoeper and A.T. Dinh-Xuan Combination therapy for pulmonary arterial hypertension: still more questions than answers Eur. Respir. J., September 1, 2004; 24(3): 339 - 340. [Full Text] [PDF]
|
|
|
|
|
|
M. Humbert, R.J. Barst, I.M. Robbins, R.N. Channick, N. Galie, A. Boonstra, L.J. Rubin, E.M. Horn, A. Manes, and G. Simonneau Combination of bosentan with epoprostenol in pulmonary arterial hypertension: BREATHE-2 Eur. Respir. J., September 1, 2004; 24(3): 353 - 359. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. M. Hoeper, R. J. Oudiz, A. Peacock, V. F. Tapson, S. G. Haworth, A. E. Frost, and A. Torbicki End points and clinical trial designs in pulmonary arterial hypertension: Clinical and regulatory perspectives J. Am. Coll. Cardiol., June 16, 2004; 43(12_Suppl_S): 48S - 55S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Galie, A. Manes, and A. Branzi The endothelin system in pulmonary arterial hypertension Cardiovasc Res, February 1, 2004; 61(2): 227 - 237. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Humbert, O. Sitbon, and G. Simonneau Novel therapeutic perspectives in pulmonary arterial hypertension Eur. Respir. J., August 1, 2003; 22(2): 193 - 194. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
