PMID- 22138355
OWN - NLM
STAT- MEDLINE
DCOM- 20120523
LR  - 20211223
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 31
IP  - 2
DP  - 2012 Feb
TI  - Usefulness of first-line combination therapy with epoprostenol and bosentan in 
      pulmonary arterial hypertension: an observational study.
PG  - 150-8
LID - 10.1016/j.healun.2011.11.002 [doi]
AB  - BACKGROUND: Recent guidelines have proposed first-line combination therapy as a 
      potential strategy for the treatment of functional class IV pulmonary arterial 
      hypertension (PAH). METHODS: We analyzed efficacy and safety of upfront 
      epoprostenol and bosentan combination therapy in consecutive patients with 
      idiopathic, heritable, or anorexigen-associated PAH and compared outcomes with 
      matched controls treated by epoprostenol monotherapy. RESULTS: Data for 16 
      functional class III patients and 7 functional class IV patients were analyzed. 
      Baseline 6-minute walk distance (6MWD) was 287 +/- 133 meters, mean pulmonary 
      artery pressure was 65 +/- 12 mm Hg, cardiac index was 1.8 +/- 0.3 L/min/m(2), and 
      pulmonary vascular resistance (PVR) was 1493 +/- 398 dynes/sec/cm(5). After 4 
      months, 6MWD and PVR significantly improved to 421 +/- 100 meters and 784 +/- 364 
      dynes/sec/cm(5), respectively. These improvements were maintained long-term (30 +/- 
      19 months). At 1, 2, 3, and 4 years, overall survival estimates were 100%, 94%, 
      94%, and 74%, and transplant-free survival estimates were 96%, 85%, 77%, and 60%, 
      respectively. Compared with matched controls started on epoprostenol monotherapy, 
      there was a trend to an improvement in overall survival (p = 0.07). CONCLUSIONS: 
      Initial combination therapy with epoprostenol and bosentan in patients with 
      severe PAH is associated with improvements in important outcomes such as 
      functional class, exercise capacity, and hemodynamics. This combination strategy 
      might also favorably affect overall and transplant-free survival.
CI  - Copyright (c) 2012 International Society for Heart and Lung Transplantation. 
      Published by Elsevier Inc. All rights reserved.
FAU - Kemp, Kristina
AU  - Kemp K
AD  - Universite Paris-Sud 11, Faculte de Medecine, Le Kremlin-Bicetre, Clamart, 
      France.
FAU - Savale, Laurent
AU  - Savale L
FAU - O'Callaghan, Dermot S
AU  - O'Callaghan DS
FAU - Jais, Xavier
AU  - Jais X
FAU - Montani, David
AU  - Montani D
FAU - Humbert, Marc
AU  - Humbert M
FAU - Simonneau, Gerald
AU  - Simonneau G
FAU - Sitbon, Olivier
AU  - Sitbon O
LA  - eng
PT  - Journal Article
DEP - 20111203
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Sulfonamides)
RN  - DCR9Z582X0 (Epoprostenol)
RN  - Q326023R30 (Bosentan)
SB  - IM
MH  - Adult
MH  - Antihypertensive Agents/administration & dosage/adverse effects/*therapeutic use
MH  - Bosentan
MH  - Case-Control Studies
MH  - Drug Therapy, Combination
MH  - Epoprostenol/administration & dosage/adverse effects/*therapeutic use
MH  - Familial Primary Pulmonary Hypertension
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/*drug therapy/physiopathology
MH  - Injections, Intravenous
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Sulfonamides/administration & dosage/adverse effects/*therapeutic use
MH  - Treatment Outcome
EDAT- 2011/12/06 06:00
MHDA- 2012/05/24 06:00
CRDT- 2011/12/06 06:00
PHST- 2011/01/17 00:00 [received]
PHST- 2011/09/12 00:00 [revised]
PHST- 2011/11/07 00:00 [accepted]
PHST- 2011/12/06 06:00 [entrez]
PHST- 2011/12/06 06:00 [pubmed]
PHST- 2012/05/24 06:00 [medline]
AID - S1053-2498(11)01203-4 [pii]
AID - 10.1016/j.healun.2011.11.002 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2012 Feb;31(2):150-8. doi: 10.1016/j.healun.2011.11.002. 
      Epub 2011 Dec 3.