Pulido ZT

Language: Spanish
References: 19
Page: 198-201
PDF size: 126.61 Kb.

ABSTRACT

Until recent years, pulmonary arterial hypertension was considered as an untreatable disease. However, with the better knowledge in its pathobiology, new drugs have been developed. These new drugs can be divided in three main groups: 1. Prostacyclin analogs (Epoprostenol, iloprost, treprostinil); 2. Endothelin antagonists (Bosentan, sitaxsentan); and 3. Phosphodiesterase-5 inhibitors (Sildenafil). Numerous studies have evaluated the safety and efficacy of these drugs, showing significant improvement in exercise capacity, quality of life and time to worsening. Some of them have even showed a better survival when compared with conventional treatment. Despite these advances, pulmonary arterial hypertension remains an incurable disease, so the focus of new studies is the combination of two or more drugs with a different mechanism of action.

REFERENCES

1. Rubin LJ: Primary pulmonary hypertension. N Engl J Med 1997; 336: 111-117.

2. Fuster V, Steele PM, Edwards WD, et al: Primary pulmonary hypertension. Natural history and the importance of thrombosis. Circulation 1984; 70: 580-587.

3. Rich S, Kaufman E, Levy PS, et al: The effect of high doses of calcium-channel blockers on survival in primary pulmonary hypertension. N Engl J Med 1992; 327: 76-81.

4. McLaughlin VV, Presberg KW, Doyle RL, Abman SH, McCrory DC, Fortin T, et al: Prognosis of pulmonary arterial hypertension. ACCP Evidence-based clinical practice guidelines. Chest 2004; 126: 78S-92S.

5. European Society of Cardiology. Guidelines on the diagnosis and treatment of pulmonary arterial hypertension. Eur Heart J 2004; 25: 2243-2278.

6. Barst RJ, Rubin LJ, Long WA, et al: A Comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension. The primary pulmonary hypertension study group. N Engl J Med 1996; 334: 296-302.

7. Olschewski H, Simonneau G, Galiè n, et al: Inhaled iloprost in severe pulmonary hypertension. N Engl J Med 2002; 347: 322-327.

8. Simonneau G, Barst RJ, Galiè N, et al: Continuous subcutaneous infusion of treprostinil, a prostacyclin analogue, in patients with pulmonary arterial hypertension : a double-blind randomized controlled trial. Am J Respir Crit Care Med 2002; 165: 800-804.

9. Tapson VF, Gomberg-Maitland M, McLaughlin VV, et al: Safety and efficacy of IV Treprostinil for pulmonary arterial hypertension. A prospective, multicenter, open-label, 12-week trial. Chest 2006; 129: 683-688.

10. Sitbon O, Humbert M, Nunes H, et al: Long-term intravenous epoprostenol infusion in primary pulmonary hypertension: prognostic factors and survival. J Am Coll Cardiol 2002; 40: 780-788.

11. McLaughlin VV, Schillington A, Rich S: Survival in primary pulmonary hypertension: the impact of epoprostenol therapy. Circulation 2002; 106: 1477-1482.

12. Channick RN, Simonneau G, Sitbon O, et al: Effects of the dual endothelin –receptor antagonist bosentan in patients with pulmonary hypertension : a randomized placebo-controlled study. Lancet 2002; 358:1119-1123.

13. Rubin RJ, Badesh DB, Barst RJ, et al: Bosentan therapy for pulmonary arterial hypertension. N Engl J Med 2002; 346: 896-903.

14. Sitbon O, Badesch DB, Channick RN, et al: Effect of the dual endothelin receptor antagonist bosentan in patients with pulmonary arterial hypertension: a one year follow-up study. Chest 2003; 124: 1380-1386.

15. Galiè n, hinderliter AL. Torbicki A, et al: Effects of the oral endothelin-receptor antagonist bosentan on echocardiographic and Doppler measures in patients with pulmonary arterial hypertension. J Am Coll Cardiol 2003; 41: 247-254.

16. Barst RJ, Langleben D, Frost A, et al: Sitaxsentan therapy for pulmonary arterial hypertension. Am J Respir Crit Care Med 2004; 169: 441-447.

17. Treatment of pulmonary arterial hypertension with the selective endothelin-A receptor antagonist Sitaxsentan. J Am Coll Cardiol 2006; 47: 2049-22056.

18. Galiè N, Ghofrani HA, Torbicki A, et al: Sildenafil citrate therapy for pulmonary arterial hypertension. N Engl J Med 2005; 353: 2148-2157.

19. Badesh DB, Abman SH, Ahearn GS, et al: Medical therapy for pulmonary arterial hypertension. ACCP evidence-based clinical practice guidelines. Chest 2004; 126: 35S-62S.