TY - JOUR
T1 - Dual phosphodiesterase type 5 inhibitor therapy for refractory pulmonary arterial hypertension
T2 - A pilot study
AU - Kimura, Mai
AU - Tamura, Yuichi
AU - Takei, Makoto
AU - Yamamoto, Tsunehisa
AU - Ono, Tomohiko
AU - Fujita, Jun
AU - Kataoka, Masaharu
AU - Kuwana, Masataka
AU - Satoh, Toru
AU - Fukuda, Keiichi
N1 - Funding Information:
This work was supported by Health and Labor Sciences Research Grants in Japan.
Publisher Copyright:
© Kimura et al.; licensee BioMed Central.
PY - 2015/5/14
Y1 - 2015/5/14
N2 - Background: Recent vasodilating drugs have improved prognosis of Pulmonary arterial hypertension (PAH). Some reports describe the merits of combination therapies for PAH, and this study evaluated the efficacy and safety of phosphodiesterase type 5 inhibitors (PDE5i) combination therapy, using sildenafil and tadalafil, for multi-drug-resistant PAH. Methods: We retrospectively analyzed 7 consecutive refractory patients with PAH administered either sildenafil 60 mg or tadalafil 40 mg as well as both ERA and prostanoid as combination therapies. All were started on the dual PDE5i (sildenafil and tadalafil at maximum dose). Results: Treatment was generally well tolerated without severe adverse events. On completion of the study, the seven patients received right heart catheterization and the 6-minute walk test (6WMT) 9.6 ± 1.4 months after initiation of the dual PDE5i therapy, showing significant improvements in hemodynamic parameters and exercise tolerance. Mean pulmonary arterial pressure and pulmonary vascular resistance decreased from 47.9 ± 9.7 to 41.7 ± 9.2 mmHg (P = 0.004) and 9.3 ± 2.7 to 6.7 ± 2.9 mmHg (P = 0.018), respectively. Cardiac index and 6MWT also increased from 2.8 ± 0.9 to 3.1 ± 0.8 L/min/m2 (P = 0.026) and 353 ± 60 to 382 ± 62 m (P = 0.014), respectively. Conclusion: The findings support dual PDE5i therapy as a new treatment option for refractory PAH.
AB - Background: Recent vasodilating drugs have improved prognosis of Pulmonary arterial hypertension (PAH). Some reports describe the merits of combination therapies for PAH, and this study evaluated the efficacy and safety of phosphodiesterase type 5 inhibitors (PDE5i) combination therapy, using sildenafil and tadalafil, for multi-drug-resistant PAH. Methods: We retrospectively analyzed 7 consecutive refractory patients with PAH administered either sildenafil 60 mg or tadalafil 40 mg as well as both ERA and prostanoid as combination therapies. All were started on the dual PDE5i (sildenafil and tadalafil at maximum dose). Results: Treatment was generally well tolerated without severe adverse events. On completion of the study, the seven patients received right heart catheterization and the 6-minute walk test (6WMT) 9.6 ± 1.4 months after initiation of the dual PDE5i therapy, showing significant improvements in hemodynamic parameters and exercise tolerance. Mean pulmonary arterial pressure and pulmonary vascular resistance decreased from 47.9 ± 9.7 to 41.7 ± 9.2 mmHg (P = 0.004) and 9.3 ± 2.7 to 6.7 ± 2.9 mmHg (P = 0.018), respectively. Cardiac index and 6MWT also increased from 2.8 ± 0.9 to 3.1 ± 0.8 L/min/m2 (P = 0.026) and 353 ± 60 to 382 ± 62 m (P = 0.014), respectively. Conclusion: The findings support dual PDE5i therapy as a new treatment option for refractory PAH.
KW - New treatment option
KW - Phosphodiesterase type 5 inhibitor
KW - Pulmonary arterial hypertension
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U2 - 10.1186/s12890-015-0037-8
DO - 10.1186/s12890-015-0037-8
M3 - Article
C2 - 25971443
AN - SCOPUS:84929332193
SN - 1471-2466
VL - 15
JO - BMC Pulmonary Medicine
JF - BMC Pulmonary Medicine
IS - 1
M1 - 62
ER -