Does Sildenafil produce a sustained benefit in patients with pulmonary hypertension associated with parenchymal lung and cardiac disease?

Madden, Brendan; Sheth, Abhijat; Wilde, M De; Ong, Yee Ean

doi:10.1016/j.vph.2007.06.003

Cited by 17 publications

(10 citation statements)

References 11 publications

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“…In a preliminary report by Collard et al [97], sildenafil improved 6MWT distance in a 3-month, open-label study which included 14 IPF patients with PH. Small uncontrolled studies have also reported sustained benefit with sildenafil in patients with secondary PH [98,99]. However, in the Sildenafil Trial of Exercise Performance in IPF study, a placebo-controlled trial which included 180 patients with advanced IPF, the therapeutic efficacy of sildenafil was not established [100].…”

Section: Treatmentmentioning

confidence: 99%

Pulmonary Hypertension in Idiopathic Pulmonary Fibrosis: A Review

2011

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Idiopathic pulmonary fibrosis (IPF) is a progressive diffuse parenchymal disease with a poor prognosis. Pulmonary hypertension (PH) often complicates the course of IPF and may even be found in patients with preserved lung function. Possible pathogenetic mechanisms of PH in IPF include vascular destruction, pulmonary hypoxic vasoconstriction and vascular remodeling due to overexpression of cytokines and growth factors. PH in IPF patients is associated with decreased exercise capacity and a worse prognosis. Due to its prognostic significance, it seems important to investigate for PH in these patients. As the symptoms of PH in IPF are nonspecific, the development of PH in a patient with known IPF can be easily overlooked. Noninvasive methods provide clues for the diagnosis, but their sensitivity is limited. Doppler echocardiography is a useful tool for the detection of PH which also provides additional information regarding associated cardiac abnormalities. However, right heart catheterization remains the gold standard diagnostic test. Therapeutic options for PH in IPF are limited. Long-term oxygen administration for the correction of hypoxemia should be recommended. The availability of new pharmacological agents in the treatment of PH has raised the possibility of therapy in patients with IPF and associated PH. Whether these PH-targeted therapies may be of benefit in this patient group, in terms of improving functional outcomes and survival, remains uncertain.

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Section: Treatmentmentioning

confidence: 99%

Pulmonary Hypertension in Idiopathic Pulmonary Fibrosis: A Review

2011

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“…Sildenafil is useful in selected patients with pulmonary hypertension. [35][36][37][38] It appears to be safe during pregnancy, but experience is limited. 39 Prostacyclin is a potent vasodilator of both the pulmonary and systemic circulations and also has important antiplatelet effects.…”

Section: The Role Of Pulmonary Vasoactive Compoundsmentioning

confidence: 99%

Pulmonary hypertension and pregnancy

Madden

2009

International Journal of Obstetric Anesthesia

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“…Although the efficacy of sildenafil or other phosphodiesterase type 5 inhibitors in treating PH associated with IPF has not been demonstrated in randomized controlled trials, encouraging results from these studies have created a moderate level of enthusiasm for their potential use in these patients. 35 Encouraging results have also been reported with iloprost in patients with pulmonary fibrosis. Olchewski et al 36 compared the acute effects of inhaled nitric oxide and inhaled iloprost to intravenous epoprostenol or oral calcium channel antagonists in 8 patients with PH associated with IPF.…”

Section: Management Of Pulmonary Hypertension In Patients With Pulmonmentioning

confidence: 95%

Diagnosis and Management of Pulmonary Hypertension Associated With Pulmonary Fibrosis

Klinger

2009

Advances in Pulmonary Hypertension

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Pulmonary hypertension (PH) occurs when mean pulmonary arterial pressure (PAP) is elevated more than 20-25 mm Hg at rest. Elevation of PAP can be caused by any process that impedes blood flow through the pulmonary circulation, including elevation of pulmonary venous pressure from left-sided heart disease. A modern classification of the pulmonary hypertensive diseases was proposed at the World Health Organization (WHO) conference on PH in Evian, France, in 1998France, in , and has been revised in 2003France, in and 2008 Using this classification system, PH associated with ILD is a subgroup of WHO Group III ( Table 1).The prevalence of PH in IPF is not well defined. Only a handful of studies have specifically tried to address how often PH oc-Advances in Pulmonary Hypertension 141

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Does Sildenafil produce a sustained benefit in patients with pulmonary hypertension associated with parenchymal lung and cardiac disease?

Cited by 17 publications

References 11 publications

Pulmonary Hypertension in Idiopathic Pulmonary Fibrosis: A Review

Pulmonary Hypertension in Idiopathic Pulmonary Fibrosis: A Review

Pulmonary hypertension and pregnancy

Diagnosis and Management of Pulmonary Hypertension Associated With Pulmonary Fibrosis

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