BACKGROUND: Prostanoids are a well-established therapy for pulmonary arterial hypertension (PAH), and observational studies suggest their efficacy even in chronic thromboembolic pulmonary hypertension (CTEPH) patients. OBJECTIVE: To compare the effects of 6 months of treatment with beraprost, an orally-active prostacyclin analog, in patients with distal CTEPH and PAH. DESIGN: Case-control study. POPULATION: Sixteen patients with severe pulmonary hypertension (NYHA II-IV), eight with distal CTEPH matched with eight patients with idiopathic PAH for similar effort tolerance. METHODS: All patients were in stable clinical and hemodynamic condition for 3 months with maximal standard therapy. During the titration phase (4 weeks) beraprost was increased to maximal tolerated dose (mean daily dosage: CTEPH 275 +/- 47 microg, PAH 277 +/- 47 microg) in adjunction of standard therapy, patients were followed-up for 6 months. MAIN OUTCOME MEASURES: World Heart Organization (WHO) functional class, exercise capacity measured by distance walked in 6 min, and systolic pulmonary pressure (echocardiography), were evaluated at baseline, and at 1-, 3- and 6-month interval. RESULTS: At 6 months WHO class decreased significantly in both groups (CTEPH from 2.7 +/- 0.6 to 2.0 +/- 0.24, p < 0.05; PAH from 3.0 +/- 0.26 to 2.1 +/- 0.25, p < 0.05), similarly the 6-min walk distance increased significantly from baseline (CTEPH from 312 +/- 31 to 373 +/- 29 m, p < 0.003; PAH from 303 +/- 31 to 347 +/- 29, p < 0.0003). Systolic pulmonary artery pressure showed a trend toward lower value (CTEPH from 85 +/- 7 m to 81 +/- 6 mm Hg, p = NS; PAH from 89 +/- 7 to 82 +/- 5, p = NS). During the observation period we did not have any death. The drug was well-tolerated with minor side-effects. CONCLUSION: In patients with CTEPH beraprost had similar mid-term clinical and hemodynamic improvements than in patients with PAH.

Mid-term efficacy of beraprost, an oral prostacyclin analog, in the treatment of distal CTEPH: A case control study / Vizza, Carmine Dario; Badagliacca, Roberto; Sciomer, Susanna; Poscia, Roberto; Alessandro, Battagliese; Mauro, Schina; Agati, Luciano; Fedele, Francesco. - In: CARDIOLOGY. - ISSN 0008-6312. - STAMPA. - 106:3(2006), pp. 168-173. [10.1159/000092920]

Mid-term efficacy of beraprost, an oral prostacyclin analog, in the treatment of distal CTEPH: A case control study

VIZZA, Carmine Dario;Roberto Badagliacca;SCIOMER, Susanna;POSCIA, ROBERTO;AGATI, Luciano;FEDELE, Francesco
2006

Abstract

BACKGROUND: Prostanoids are a well-established therapy for pulmonary arterial hypertension (PAH), and observational studies suggest their efficacy even in chronic thromboembolic pulmonary hypertension (CTEPH) patients. OBJECTIVE: To compare the effects of 6 months of treatment with beraprost, an orally-active prostacyclin analog, in patients with distal CTEPH and PAH. DESIGN: Case-control study. POPULATION: Sixteen patients with severe pulmonary hypertension (NYHA II-IV), eight with distal CTEPH matched with eight patients with idiopathic PAH for similar effort tolerance. METHODS: All patients were in stable clinical and hemodynamic condition for 3 months with maximal standard therapy. During the titration phase (4 weeks) beraprost was increased to maximal tolerated dose (mean daily dosage: CTEPH 275 +/- 47 microg, PAH 277 +/- 47 microg) in adjunction of standard therapy, patients were followed-up for 6 months. MAIN OUTCOME MEASURES: World Heart Organization (WHO) functional class, exercise capacity measured by distance walked in 6 min, and systolic pulmonary pressure (echocardiography), were evaluated at baseline, and at 1-, 3- and 6-month interval. RESULTS: At 6 months WHO class decreased significantly in both groups (CTEPH from 2.7 +/- 0.6 to 2.0 +/- 0.24, p < 0.05; PAH from 3.0 +/- 0.26 to 2.1 +/- 0.25, p < 0.05), similarly the 6-min walk distance increased significantly from baseline (CTEPH from 312 +/- 31 to 373 +/- 29 m, p < 0.003; PAH from 303 +/- 31 to 347 +/- 29, p < 0.0003). Systolic pulmonary artery pressure showed a trend toward lower value (CTEPH from 85 +/- 7 m to 81 +/- 6 mm Hg, p = NS; PAH from 89 +/- 7 to 82 +/- 5, p = NS). During the observation period we did not have any death. The drug was well-tolerated with minor side-effects. CONCLUSION: In patients with CTEPH beraprost had similar mid-term clinical and hemodynamic improvements than in patients with PAH.
2006
beraprost; chronic thromboembolic pulmonary hypertension; prostacyclin; pulmonary arterial hypertension
01 Pubblicazione su rivista::01a Articolo in rivista
Mid-term efficacy of beraprost, an oral prostacyclin analog, in the treatment of distal CTEPH: A case control study / Vizza, Carmine Dario; Badagliacca, Roberto; Sciomer, Susanna; Poscia, Roberto; Alessandro, Battagliese; Mauro, Schina; Agati, Luciano; Fedele, Francesco. - In: CARDIOLOGY. - ISSN 0008-6312. - STAMPA. - 106:3(2006), pp. 168-173. [10.1159/000092920]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/362058
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