Pulmonary arterial hypertension is a severe disease with a complex pathogenesis, for which combination therapy is an attractive option.This study aimed to assess the impact of sequential combination therapy on both short-term responses and long-term outcomes in a real-world setting.Patients with idiopathic/heritable pulmonary arterial hypertension, or pulmonary arterial hypertension associated with congenital heart disease or connective tissue disease and who were not meeting treatment goals on either first-line bosentan or sildenafil monotherapy, were given additional sildenafil or bosentan and assessed after 3-4 months. Double combination therapy significantly improved clinical and haemodynamic parameters, independent of aetiology or the order of drug administration. Significant improvements in functional class were observed in patients with idiopathic/heritable pulmonary arterial hypertension. The 1-, 3- and 5-year overall survival estimates were 91%, 69% and 59%, respectively. Patients with pulmonary arterial hypertension associated with connective tissue disease had significantly poorer survival rates compared to other aetiologies (p<0.003).The favourable short-term haemodynamic results and good survival rates, observed in patients receiving both bosentan and sildenafil, supports the use of sequential combination therapy in patients failing on monotherapy in a real-world setting.

Combining bosentan and sildenafil in pulmonary arterial hypertension patients failing monotherapy: Real-world insights / Dardi, F.; Manes, A.; Palazzini, M.; Bachetti, C.; Mazzanti, G.; Rinaldi, A.; Albini, A.; Gotti, E.; Monti, E.; Reggiani, M.L.B.; Galie, N.. - In: EUROPEAN RESPIRATORY JOURNAL. - ISSN 0903-1936. - STAMPA. - 46:2(2015), pp. 414-421. [10.1183/09031936.00209914]

Combining bosentan and sildenafil in pulmonary arterial hypertension patients failing monotherapy: Real-world insights

DARDI, FABIO;MANES, ALESSANDRA;PALAZZINI, MASSIMILIANO;BACHETTI, CRISTINA;MAZZANTI, GAIA;RINALDI, ANDREA;ALBINI, ALESSANDRA;GOTTI, ENRICO;MONTI, ENRICO;BACCHI REGGIANI, MARIA LETIZIA;GALIE', NAZZARENO
2015

Abstract

Pulmonary arterial hypertension is a severe disease with a complex pathogenesis, for which combination therapy is an attractive option.This study aimed to assess the impact of sequential combination therapy on both short-term responses and long-term outcomes in a real-world setting.Patients with idiopathic/heritable pulmonary arterial hypertension, or pulmonary arterial hypertension associated with congenital heart disease or connective tissue disease and who were not meeting treatment goals on either first-line bosentan or sildenafil monotherapy, were given additional sildenafil or bosentan and assessed after 3-4 months. Double combination therapy significantly improved clinical and haemodynamic parameters, independent of aetiology or the order of drug administration. Significant improvements in functional class were observed in patients with idiopathic/heritable pulmonary arterial hypertension. The 1-, 3- and 5-year overall survival estimates were 91%, 69% and 59%, respectively. Patients with pulmonary arterial hypertension associated with connective tissue disease had significantly poorer survival rates compared to other aetiologies (p<0.003).The favourable short-term haemodynamic results and good survival rates, observed in patients receiving both bosentan and sildenafil, supports the use of sequential combination therapy in patients failing on monotherapy in a real-world setting.
2015
Combining bosentan and sildenafil in pulmonary arterial hypertension patients failing monotherapy: Real-world insights / Dardi, F.; Manes, A.; Palazzini, M.; Bachetti, C.; Mazzanti, G.; Rinaldi, A.; Albini, A.; Gotti, E.; Monti, E.; Reggiani, M.L.B.; Galie, N.. - In: EUROPEAN RESPIRATORY JOURNAL. - ISSN 0903-1936. - STAMPA. - 46:2(2015), pp. 414-421. [10.1183/09031936.00209914]
Dardi, F.; Manes, A.; Palazzini, M.; Bachetti, C.; Mazzanti, G.; Rinaldi, A.; Albini, A.; Gotti, E.; Monti, E.; Reggiani, M.L.B.; Galie, N.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/534436
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