The use of sildenafil to treat pulmonary hypertension associated with interstitial lung disease

Corte, Tamera J.; Parfitt, Lisa; Harries, Carl; Wells, Athol U.; Wort, Stephen J.

doi:10.1111/j.1440-1843.2010.01860.x

Cited by 41 publications

(42 citation statements)

References 58 publications

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“…13,14,16 We were reassured by published data indicating that treatment with PDE-5 inhibitors is safe and well tolerated. 13,14,24,25 PDE-5 inhibitors are routinely used in patients with PAH and lead to an improvement of 6MWD in these patients.…”

Section: Figuresupporting

confidence: 54%

“…24,25 However, our data differs from an analysis of a subgroup in patients with echocardiographic evidence of PH who showed an improvement in 6MWD. 14,15 The main finding in our study was that in eight out of 10 patients, a sustained improvement in haemodynamics could be achieved, suggesting a possible subgroup of PH-ILD patients who may benefit from PDE-5 inhibitors. In an attempt to define a PAHphenotype within ILD patients with PH, the German Cologne Consensus Conference has suggested haemodynamic criteria.…”

Section: Figurementioning

confidence: 88%

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Haemodynamic changes in pulmonary hypertension in patients with interstitial lung disease treated with PDE‐5 inhibitors

et al. 2014

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Section: Figuresupporting

confidence: 54%

Section: Figurementioning

confidence: 88%

Haemodynamic changes in pulmonary hypertension in patients with interstitial lung disease treated with PDE‐5 inhibitors

et al. 2014

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“…In PH-ILD, sildenafil appears to be safe and well tolerated, and has had a significant effect on 6-min walk distance (6MWD) and BNP levels but not on RVSP after 6 months of treatment in small cohorts [82]. In sarcoidosis, sildenafil has improved mean pulmonary arterial pressure and cardiac output in repeat RHC 4 months after treatment [83].…”

Section: Treatmentmentioning

confidence: 99%

Comorbidities in interstitial lung diseases

2017

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Fibrosing lung disorders include a large number of diseases with diverse behaviour. Patients can die because of the progression of their illness, remain stable or even improve after appropriate treatment has been instituted. Comorbidities, such as acute and chronic infection, gastro-oesophageal reflux, pulmonary hypertension, lung cancer, cardiovascular diseases, and obstructive sleep apnoea, can pre-exist or develop at any time during the course of the disease and, if unidentified and untreated, may impair quality of life, impact upon the respiratory status of the patients, and ultimately lead to disease progression and death. Therefore, early identification and accurate treatment of comorbidities is essential.

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“…Sildenafil has been shown to reduce hypoxia-induced pulmonary hypertension, and to be useful for reducing PVR in patients with interstitial pneumonia, without reducing the ventilation-perfusion ratio. [30][31][32] Tadalafil has been approved for use as a pulmonary vasodilator in patients with hypoxic pulmonary hypertension, and has also been reported to be effective for the treatment of chronic obstructive pulmonary disease. 33) These findings may help to explain the efficacy of sildenafil treatment in the patients in this study with ventilatory impairment.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Pulmonary Vasodilator Therapy in Patients With Functionally Single Ventricle

Park

2015

Int. Heart J.

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SummaryThis study retrospectively evaluated the effectiveness of pulmonary vasodilator therapy with bosentan (n = 14) and/ or sildenafil (n = 23) in 34 patients with a functionally single ventricle. Vasodilator therapy was initiated before the Fontan procedure in 18 patients and after the procedure in 16 patients. The reasons for vasodilator treatment included high pulmonary artery pressure or pulmonary vascular resistance (n = 8), high central venous pressure after the Fontan or bidirectional Glenn procedure (n = 7), and ventilatory impairment (n = 8). In the 11 patients who underwent right heart catheterization before and after the initiation of therapy, the mean pulmonary artery pressure decreased significantly from 19.5 ± 5.5 mmHg to 14.3 ± 3.0 mmHg (P = 0.023) and the transpulmonary pressure gradient decreased significantly from 10.9 ± 4.6 mmHg to 7.2 ± 3.3 mmHg (P = 0.046). Of the 18 patients who started vasodilator therapy before the Fontan procedure, 10 survived surgery, 4 are awaiting surgery, 3 had not been evaluated for the Fontan procedure at the end of the study period, and 1 died of heart failure after discontinuing bosentan therapy. There were no deaths among the patients who started therapy after the Fontan procedure. Two of the 14 patients receiving bosentan discontinued treatment because of adverse effects (hepatic dysfunction and increased serum brain natriuretic peptide level). Bosentan or sildenafil therapy is usually safe and may contribute to reducing pulmonary vascular resistance in patients with a functionally single ventricle before and after a Fontan type operation. (Int Heart J 2015; 56: S26-S30)

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The use of sildenafil to treat pulmonary hypertension associated with interstitial lung disease

Abstract: Our observations suggest that sildenafil may be useful in the management of PH in ILD. Controlled trials are warranted before therapeutic recommendations can be made.

Cited by 41 publications

References 58 publications

Haemodynamic changes in pulmonary hypertension in patients with interstitial lung disease treated with PDE‐5 inhibitors

Haemodynamic changes in pulmonary hypertension in patients with interstitial lung disease treated with PDE‐5 inhibitors

Comorbidities in interstitial lung diseases

Efficacy of Pulmonary Vasodilator Therapy in Patients With Functionally Single Ventricle

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