Abstract
Pulmonary hypertension is a serious complication of chronic obstructive pulmonary disease (COPD) that currently has no established pharmacological treatment. This study aimed to assess whether concomitant treatment with sildenafil would enhance the results of pulmonary rehabilitation in patients with COPD and increased pulmonary arterial pressure (PAP).
In this double-blind, randomised controlled trial patients received 20 mg sildenafil or placebo three times daily and underwent pulmonary rehabilitation for 3 months. The primary end-point was the gain in the cycle endurance time at a constant work-rate. Secondary end-points included performance in the incremental exercise test, 6-min walk distance and quality of life.
63 patients with severe COPD and moderately increased PAP were randomised. Cycle endurance time increased by 149 s (95% CI 26–518 s) in the sildenafil group and by 169 s (95% CI 0–768 s) in the placebo group (median change difference -7 s, 95% CI -540–244 s; p=0.77). Gains in the incremental exercise test, 6-min walk distance and quality of life at the end of the study did not differ between groups. Measurements of arterial oxygenation and adverse events were similar in both groups.
In patients with severe COPD and moderately increased PAP, concomitant treatment with sildenafil does not improve the results of pulmonary rehabilitation in exercise tolerance.
Abstract
Sildenafil did not improve respiratory rehabilitation outcomes in patients with severe COPD and moderately increased PAP http://ow.ly/lh7cb
Footnotes
For editorial comments see page 893.
This article has supplementary material available from www.erj.ersjournals.com
Clinical trial: This study is registered at www.clinicaltrials.gov with identifier number NCT01055405.
Support statement: The study was supported by grants from the Fondo de Investigación Sanitaria, Instituto de Salud Carlos III (EC07/90049), Pulmotension (EU IP-018723) and Societat Catalana de Pneumologia. I. Blanco was the recipient of a Research Training Fellowship from the Sociedad Española de Neumología y Cirugía Torácica. Sildenafil and placebo tablets were donated by Pfizer Inc (Sandwich, UK).
Conflict of interest: Disclosures can be found alongside the online version of this manuscript at www.erj.ersjournals.com
- Received November 1, 2012.
- Accepted January 25, 2013.
- ©ERS 2013