PMID- 16633955
OWN - NLM
STAT- MEDLINE
DCOM- 20060524
LR  - 20221212
IS  - 1424-7860 (Print)
IS  - 0036-7672 (Linking)
VI  - 136
IP  - 7-8
DP  - 2006 Feb 18
TI  - Long-term experience with oral or inhaled vasodilator combination therapy in 
      patients with pulmonary hypertension.
PG  - 114-8
AB  - BACKGROUND: Disease progression in pulmonary hypertension (PH) is common despite 
      standard vasodilator monotherapy with iloprost, bosentan or sildenafil. 
      OBJECTIVE: To investigate if the combination of these non-invasively applicable 
      treatments is an effective option to address the multiple pathophysiological 
      mechanisms present in PH. METHODS: We analysed the clinical course of 23 patients 
      with PH, diagnosed as idiopathic (n = 15), chronic thromboembolic (n = 4), and 
      associated with collagen vascular disease (n = 4), receiving combination 
      vasodilator therapy at our institution. RESULTS: Vasodilator therapy before 
      combination therapy consisted of inhaled iloprost (I; n = 12), or oral bosentan 
      (B; n = 6) at a mean duration of 19 +/- 3 months. The combination therapy added 
      was B (n = 8), sildenafil (S; n = 6) or I (n = 4) and in five patients, 
      combination therapy was given from the beginning (3x BS, 1x IS, 1x IBS). Under 
      combination therapy, the 6-minute walk distance (6MWD) increased significantly by 
      46.7 +/- 24.8 m (p = 0.02) after three months, and after six months it was still 
      38.3 +/- 28.3 m (p = 0.17) longer than before combination therapy. Respective 
      changes in the Borg Scale and the NYHA functional class were -1.05 +/- 0.49 (p = 
      0.014) and -0.42 +/- 0.19 (p = 0.02) after three months and -0.21 +/- 0.65 (p = 
      0.61) and -0.38 +/- 0.29 (p = 0.26) after six months. Only minor side effects 
      were reported. CONCLUSION: Combination vasodilator therapy in severe PH is safe 
      and well tolerated. It significantly improves exercise capacity and stabilises 
      the functional class in patients with severe PH deteriorating under single-agent 
      therapy.
FAU - Beyer, Swantje
AU  - Beyer S
AD  - Department of Internal Medicine, University Hospital Zurich, Switzerland.
FAU - Speich, Rudolf
AU  - Speich R
FAU - Fischler, Manuel
AU  - Fischler M
FAU - Maggiorini, Marco
AU  - Maggiorini M
FAU - Ulrich, Silvia
AU  - Ulrich S
LA  - eng
PT  - Journal Article
PL  - Switzerland
TA  - Swiss Med Wkly
JT  - Swiss medical weekly
JID - 100970884
RN  - 0 (Vasodilator Agents)
SB  - IM
MH  - Administration, Inhalation
MH  - Administration, Oral
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/*drug therapy/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Switzerland
MH  - Vasodilator Agents/*administration & dosage
EDAT- 2006/04/25 09:00
MHDA- 2006/05/25 09:00
CRDT- 2006/04/25 09:00
PHST- 2006/04/25 09:00 [pubmed]
PHST- 2006/05/25 09:00 [medline]
PHST- 2006/04/25 09:00 [entrez]
AID - smw-11258 [pii]
AID - 10.4414/smw.2006.11258 [doi]
PST - ppublish
SO  - Swiss Med Wkly. 2006 Feb 18;136(7-8):114-8. doi: 10.4414/smw.2006.11258.