PT  - JOURNAL ARTICLE
AU  - Sitbon, Olivier
AU  - Sattler, Caroline
AU  - Bertoletti, Laurent
AU  - Savale, Laurent
AU  - Cottin, Vincent
AU  - Jaïs, Xavier
AU  - De Groote, Pascal
AU  - Chaouat, Ari
AU  - Chabannes, Céline
AU  - Bergot, Emmanuel
AU  - Bouvaist, Hélène
AU  - Dauphin, Claire
AU  - Bourdin, Arnaud
AU  - Bauer, Fabrice
AU  - Montani, David
AU  - Humbert, Marc
AU  - Simonneau, Gérald
TI  - Initial dual oral combination therapy in pulmonary arterial hypertension
AID  - 10.1183/13993003.02043-2015
DP  - 2016 Jun 01
TA  - European Respiratory Journal
PG  - 1727--1736
VI  - 47
IP  - 6
4099  - http://erj.ersjournals.com/content/47/6/1727.short
4100  - http://erj.ersjournals.com/content/47/6/1727.full
SO  - Eur Respir J2016 Jun 01; 47
AB  - Treatment for pulmonary arterial hypertension (PAH) has been underpinned by single-agent therapy to which concomitant drugs are added sequentially when pre-defined treatment goals are not met.This retrospective analysis of real-world clinical data in 97 patients with newly diagnosed PAH (86% in New York Heart Association functional class III−IV) explored initial dual oral combination treatment with bosentan plus sildenafil (n=61), bosentan plus tadalafil (n=17), ambrisentan plus tadalafil (n=11) or ambrisentan plus sildenafil (n=8).All regimens were associated with significant improvements in functional class, exercise capacity, dyspnoea and haemodynamic indices after 4 months of therapy. Over a median follow-up period of 30 months, 75 (82%) patients were still alive, 53 (71%) of whom received only dual oral combination therapy. Overall survival rates were 97%, 94% and 83% at 1, 2 and 3 years, respectively, and 96%, 94% and 84%, respectively, for the patients with idiopathic PAH, heritable PAH and anorexigen-induced PAH. Expected survival rates calculated from the French equation for the latter were 86%, 75% and 66% at 1, 2 and 3 years, respectively.Initial combination of oral PAH-targeted medications may offer clinical benefits, especially in PAH patients with severe haemodynamic impairment.Initial dual combination therapy may offer potential benefits in PAH patients with severe haemodynamic impairment http://ow.ly/YNxgk