Document Detail


Longer-term bosentan therapy improves functional capacity in Eisenmenger syndrome: results of the BREATHE-5 open-label extension study.
MedLine Citation:
PMID:  17658633     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Bosentan, an oral endothelin ET(A)/ET(B) receptor antagonist, improves hemodynamics and exercise capacity in patients with Eisenmenger syndrome but longer-term effects are unknown. This study investigated the efficacy and safety of bosentan up to 40 weeks in these patients. METHODS: Following the 16-week, double blind, placebo-controlled BREATHE-5 study of bosentan in patients with Eisenmenger syndrome, an open-label extension (OLE) was performed. Patients who completed BREATHE-5 received bosentan for an additional 24 weeks (62.5 mg b.i.d. for 4 weeks, then 125 mg b.i.d.) and were analyzed in two groups; ex-placebo and ex-bosentan, according to BREATHE-5 treatment. RESULTS: Thirty-seven patients with Eisenmenger syndrome who participated in BREATHE-5 were included in the OLE. At week 24, the 6-minute walk distance (mean+/-SE) increased from OLE baseline for the ex-placebo (+33.2+/-23.9 m) and ex-bosentan group (+6.7+/-10.0 m). The overall improvement from baseline of BREATHE-5 was +61.3+/-8.1 m (95% confidence interval: [44.7, 78.0]) for the ex-bosentan group. WHO functional class was improved in both groups. Bosentan did not reduce systemic arterial blood oxygen saturation; safety profile was comparable to previous trials. CONCLUSIONS: In conclusion, these longer follow-up data support the efficacy and safety profile reported in the preceding BREATHE-5 study of bosentan treatment of Eisenmenger syndrome, challenging the notion that pulmonary vascular disease and severe functional impairment in these patients are not amenable to therapy.
Authors:
Michael A Gatzoulis; Maurice Beghetti; Nazzareno Galiè; John Granton; Rolf M F Berger; Andrea Lauer; Eleonora Chiossi; Michael Landzberg;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-07-20
Journal Detail:
Title:  International journal of cardiology     Volume:  127     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-27     Completed Date:  2008-07-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  27-32     Citation Subset:  IM    
Affiliation:
Royal Brompton Hospital and the National Heart and Lung Institute, Imperial College, London, UK. m.gatzoulis@rbh.nthames.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antihypertensive Agents / administration & dosage*
Double-Blind Method
Drug Administration Schedule
Eisenmenger Complex / drug therapy*,  physiopathology*
Exercise Tolerance*
Female
Humans
Male
Middle Aged
Sulfonamides / administration & dosage*
Treatment Outcome
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Sulfonamides; 147536-97-8/bosentan
Investigator
Investigator/Affiliation:
John Hess / ; Alessandra Manes / ; Mario Vigano / ; Elke S Hoendermis / ; José Maria Oliver / ; W Stewart Hillis / ; Carl Harries / ; Dorothy D Pearson /

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


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