Tadalafil Therapy for Pulmonary Arterial Hypertension

“…In the PHIRST study [157,167], the combination of tadalafil and bosentan resulted in an improvement of exercise capacity of borderline statistical significance (subgroup analysis). For these two compounds a pharmacokinetic interaction has also been shown (table 20).…”

Section: Combination Therapymentioning

confidence: 97%

Guidelines for the diagnosis and treatment of pulmonary hypertension

Galiè¹,

Hoeper²,

Humbert³

et al. 2012

Revista Portuguesa de Cardiologia (English Edition)

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“…This finding highlights its important role as a clinical test, as it stands out for its practicability in daily routine. With the exception of the registration trial for macitentan, a new dual endothelin antagonist, the 6-MWT has been used as the primary end-point in registration trials for all PAH medications [23][24][25][26]. However, recent publications have criticised the application of the 6-MWT as a primary end-point, indicating that changes in 6-MWT might not reflect benefits in outcome, and proposed new end-points such as time to clinical worsening [27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Novel biomarkers for risk stratification in pulmonary arterial hypertension

et al. 2016

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Risk stratification in pulmonary arterial hypertension (PAH) is paramount to identifying individuals at highest risk of death. So far, there are only limited parameters for prognostication in patients with PAH.95 patients with confirmed PAH were included in the present analysis and followed for a total of 4 years. Blood samples were analysed for serum levels of N-terminal pro-brain natriuretic peptide, highsensitivity troponin T (hsTnT), pro-atrial natriuretic peptide ( proANP), growth differentiation factor 15, soluble fms-like tyrosine kinase 1 and placental growth factor. 27 (28.4%) patients died during a follow-up of 4 years. Levels of all tested biomarkers, except for placental growth factor, were significantly elevated in nonsurvivors compared with survivors. Receiver operating characteristic analyses demonstrated that cardiac biomarkers had the highest power in predicting mortality. In particular, proANP exhibited the highest area under the curve, followed by N-terminal probrain natriuretic peptide and hsTnT. Furthermore, proANP and hsTnT added significant additive prognostic value to the established markers in categorical and continuous net reclassification index. Moreover, after Cox regression, proANP (hazard ratio (HR) 1.91), hsTnT (HR 1.41), echocardiographic right ventricular impairment (HR 1.30) and 6-min walk test (HR 0.97 per 10 m) remained the only significant parameters in prognostication of mortality.Our data suggest benefits of the implementation of proANP and hsTnT as additive biomarkers for risk stratification in patients with PAH. @ERSpublications The cardiac biomarkers proANP and hsTnT may be of use in the assessment of risk stratification in PAH patients http://ow.ly/RJFtn

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“…This trial was a 16-week, randomised, double-blind, placebo-controlled multicentre trial which studied the efficacy and tolerability of 4 doses of tadalafil on 405 PAH subjects with and without background bosentan therapy. 80 40 mg of tadalafil had significantly reduced the incidence of clinical worsening and improved time to clinical worsening when compared to placebo. This drug improved exercise capacity in a dose dependent manner, but only the 40mg dose met the pre-specified value for statistical significance of <0.01.…”

Section: Sildenafilmentioning

confidence: 92%

Pulmonary hypertension—“state of the art” management in 2012

Saxena

2012

Indian Heart Journal

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A B S T R A C TPulmonary artery hypertension (PAH) is a pathological condition of small pulmonary arteries, characterised by vascular proliferation and remodelling. The pulmonary artery pressure and pulmonary vascular resistance progressively rise, leading to right heart failure and death. Pulmonary artery hypertension may be secondary to various conditions, or it may be idiopathic where no underlying cause is identifiable. Earlier, only symptomatic treatment was available for such patients which did not change the natural history of the disease. However, over the years, improvement in understanding the pathogenesis has resulted in the development of targeted approaches to the treatment of PAH. Survival advantage has also been shown with some of the pharmacologic agents. This review article discusses the current management strategy for PAH with special emphasis on an idiopathic variety, in an Indian context.

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Tadalafil Therapy for Pulmonary Arterial Hypertension

Abstract: In patients with pulmonary arterial hypertension, tadalafil 40 mg was well tolerated and improved exercise capacity and quality of life measures and reduced clinical worsening.

Cited by 957 publications

References 38 publications

Guidelines for the diagnosis and treatment of pulmonary hypertension

Guidelines for the diagnosis and treatment of pulmonary hypertension

Novel biomarkers for risk stratification in pulmonary arterial hypertension

Pulmonary hypertension—“state of the art” management in 2012

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