Combining bosentan and sildenafil in pulmonary arterial hypertension patients failing monotherapy: real-world insights.
Eur Respir J
; 46(2): 414-21, 2015 Aug.
Article
en En
| MEDLINE
| ID: mdl-26022952
ABSTRACT
Pulmonary arterial hypertension is a severe disease with a complex pathogenesis, for which combination therapy is an attractive option.This study aimed to assess the impact of sequential combination therapy on both short-term responses and long-term outcomes in a real-world setting.Patients with idiopathic/heritable pulmonary arterial hypertension, or pulmonary arterial hypertension associated with congenital heart disease or connective tissue disease and who were not meeting treatment goals on either first-line bosentan or sildenafil monotherapy, were given additional sildenafil or bosentan and assessed after 3-4 months. Double combination therapy significantly improved clinical and haemodynamic parameters, independent of aetiology or the order of drug administration. Significant improvements in functional class were observed in patients with idiopathic/heritable pulmonary arterial hypertension. The 1-, 3- and 5-year overall survival estimates were 91%, 69% and 59%, respectively. Patients with pulmonary arterial hypertension associated with connective tissue disease had significantly poorer survival rates compared to other aetiologies (p<0.003).The favourable short-term haemodynamic results and good survival rates, observed in patients receiving both bosentan and sildenafil, supports the use of sequential combination therapy in patients failing on monotherapy in a real-world setting.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Sulfonamidas
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Vasodilatadores
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Hipertensión Pulmonar Primaria Familiar
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Citrato de Sildenafil
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Hipertensión Pulmonar
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Antihipertensivos
Tipo de estudio:
Observational_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Aged80
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Child
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Eur Respir J
Año:
2015
Tipo del documento:
Article
País de afiliación:
Italia