Document Detail

Sildenafil for pulmonary hypertension.
MedLine Citation:
PMID:  15827074     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the efficacy of sildenafil for treatment of pulmonary hypertension. DATA SOURCES: Literature retrieval was accessed through MEDLINE (1977-March 2005), Cochrane Library, and International Pharmaceutical Abstracts (1977-March 2005) using the terms sildenafil and pulmonary hypertension. In addition, reference citations from publications identified were reviewed. STUDY SELECTION AND DATA EXTRACTION: All articles in English identified from the data sources were evaluated. Studies including >5 patients with primarily adult populations were included in the review. DATA SYNTHESIS: The treatment of pulmonary hypertension is challenging. Sildenafil has recently been studied as monotherapy and in combination with other vasodilators in the management of pulmonary hypertension. Eight hemodynamic studies and 12 clinical trials were reviewed (1 retrospective, 3 double-blind, 8 open-label). Sildenafil reduced pulmonary arterial hypertension and pulmonary vascular resistance/peripheral vascular resistance index and tended to increase cardiac output/cardiac index compared with baseline. Sildenafil was comparable to nitric oxide and at least as effective as iloprost or epoprostenol in terms of its pulmonary vasoreactivity. Combination therapy with iloprost, nitric oxide, or epoprostenol resulted in enhanced and prolonged pulmonary vascular effects. Clinical trials suggest that sildenafil improves exercise tolerance and New York Heart Association functional class, but large, randomized controlled trials are needed to confirm these findings. Overall, sildenafil was well tolerated. CONCLUSIONS: Overall, sildenafil is a promising and well-tolerated agent for management of pulmonary hypertension. Further well-designed trials are warranted to establish its place in the treatment of pulmonary hypertension.
Audrey J Lee; Teresa B Chiao; Mildred P Tsang
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Publication Detail:
Type:  Journal Article; Review     Date:  2005-04-12
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  39     ISSN:  1060-0280     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-04-21     Completed Date:  2005-09-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  869-84     Citation Subset:  IM    
Thomas J Long School of Pharmacy, University of the Pacific, Veterans Affairs Medical Center, San Francisco, CA, USA.
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MeSH Terms
Double-Blind Method
Drug Therapy, Combination
Epoprostenol / therapeutic use*
Hypertension, Pulmonary / diagnosis,  drug therapy*
Iloprost / therapeutic use*
Middle Aged
Phosphodiesterase Inhibitors / pharmacology,  therapeutic use*
Piperazines / pharmacology,  therapeutic use*
Randomized Controlled Trials as Topic
Vasodilator Agents / therapeutic use*
Reg. No./Substance:
0/Phosphodiesterase Inhibitors; 0/Piperazines; 0/Purines; 0/Sulfones; 0/Vasodilator Agents; 139755-83-2/sildenafil; 35121-78-9/Epoprostenol; 78919-13-8/Iloprost

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

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