A potential role for sildenafil in the management of pulmonary hypertension in patients with parenchymal lung disease

Madden, Brendan; Allenby, Mark I.; Loke, Tuck-Kay; Sheth, Abhijat

doi:10.1016/j.vph.2006.01.013

Cited by 106 publications

(63 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Open label, uncontrolled observations with both bosentan and sildenafil have suggested benefit, although adequately designed trials are lacking. [201][202][203] Worsening V/Q mismatch, resulting in further hypoxemia due to nonselective vasodilatation is a potential risk.…”

Section: Chronic Obstructive Pulmonary Disease and Pulmonary Hypertenmentioning

confidence: 99%

ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension

McLaughlin¹,

Archer²,

Badesch³

et al. 2009

Circulation

1,077

605

View full text Add to dashboard Cite

Section: Chronic Obstructive Pulmonary Disease and Pulmonary Hypertenmentioning

confidence: 99%

ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension

McLaughlin¹,

Archer²,

Badesch³

et al. 2009

Circulation

1,077

605

View full text Add to dashboard Cite

“…Sildenafil has been shown to improve exercise tolerance in pulmonary arterial hypertension [8], but previous studies with sildenafil in COPD patients have yielded discrepant results. In two open-label studies conducted in a limited number of patients, sildenafil, used at doses higher than those currently approved for pulmonary arterial hypertension, improved exercise tolerance and pulmonary haemodynamics [29,30]. In contrast, RIETEMA et al [31] did not show differences in exercise tolerance and stroke volume in an uncontrolled study conducted in 14 COPD patients treated with conventional sildenafil doses.…”

Section: Discussionmentioning

confidence: 96%

Sildenafil to improve respiratory rehabilitation outcomes in COPD: a controlled trial

et al. 2013

View full text Add to dashboard Cite

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; p50.77). 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. @ERSpublications Sildenafil did not improve respiratory rehabilitation outcomes in patients with severe COPD and moderately increased PAP

show abstract

“…Treatment with conventional vasodilators is not recommended because they may impair gas exchange due to the inhibition of hypoxic pulmonary vasoconstriction [241,242] and their lack of efficacy after long-term use [243,244]. Published experience with specific PAH drug therapy is scarce and consists of the assessment of acute effects [245,246] and uncontrolled studies in small series [247][248][249][250][251].…”

Section: Therapymentioning

confidence: 99%