Document Detail


Long-term ambrisentan therapy for the treatment of pulmonary arterial hypertension.
MedLine Citation:
PMID:  19909879     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study evaluated the safety and efficacy of ambrisentan for a period of 2 years in patients with pulmonary arterial hypertension (PAH). BACKGROUND: Ambrisentan is an oral, once-daily endothelin receptor antagonist that is selective for the endothelin type A receptor. The ARIES-1 (Ambrisentan in Pulmonary Arterial Hypertension, Randomized, Double-Blind, Placebo-Controlled, Multicenter, Efficacy Studies) and ARIES-2 trials were the pivotal 12-week, placebo-controlled studies that led to the regulatory approval of ambrisentan (5 and 10 mg) for the treatment of PAH. METHODS: In the ARIES-1 and -2 studies, and the subsequent long-term extension protocol, the ARIES-E study, 383 patients received ambrisentan (2.5, 5, or 10 mg). Efficacy and safety assessments are presented from the time of the first dose of ambrisentan for all patients with post-baseline data. RESULTS: After 2 years of ambrisentan exposure, the mean change from baseline in 6-min walk distance was improved for the 5-mg (+23 m; 95% confidence interval: 9 to 38 m) and 10-mg (+28 m; 95% confidence interval: 11 to 45 m) groups. Estimates of survival and freedom from clinical worsening for the combined dose group were 94% and 83%, respectively, at 1 year and 88% and 72%, respectively, at 2 years. The annualized risk of aminotransferase abnormalities >3x the upper limit of normal was approximately 2% per year; most of these events were mild and did not lead to discontinuation of drug. CONCLUSIONS: Two years of ambrisentan treatment was associated with sustained improvements in exercise capacity and a low risk of clinical worsening and death in patients with PAH. Ambrisentan was generally well tolerated and had a low risk of aminotransferase abnormalities over the 2-year study period. (A Long Term Study of Ambrisentan in Pulmonary Arterial Hypertension Subjects Having Completed AMB-320 or AMB-321; NCT00578786).
Authors:
Ronald J Oudiz; Nazzareno Galiè; Horst Olschewski; Fernando Torres; Adaani Frost; Hossein A Ghofrani; David B Badesch; Michael D McGoon; Vallerie V McLaughlin; Ellen B Roecker; Brooke C Harrison; Darrin Despain; Christopher Dufton; Lewis J Rubin;
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  54     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-13     Completed Date:  2009-12-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1971-81     Citation Subset:  AIM; IM    
Affiliation:
LA Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, USA. roudiz@labiomed.org
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Dose-Response Relationship, Drug
Double-Blind Method
Exercise Tolerance / drug effects
Female
Follow-Up Studies
Humans
Hypertension, Pulmonary / drug therapy*,  mortality,  physiopathology
Male
Middle Aged
Phenylpropionates / administration & dosage*
Pulmonary Wedge Pressure / drug effects
Pyridazines / administration & dosage*
Survival Rate / trends
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Phenylpropionates; 0/Pyridazines; 177036-94-1/ambrisentan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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