Long-term effects of bosentan in patients with HIV-associated pulmonary arterial hypertension.

Abstract

Bosentan has proven 4-month efficacy in patients with HIV-associated pulmonary arterial hypertension (PAH-HIV). Herein, the long-term outcome of unselected PAH-HIV patients treated with first-line bosentan is described. Data for 59 consecutive World Health Organization (WHO) functional class II-IV PAH-HIV patients treated with first-line bosentan between May 2002 and July 2007 were analysed. HIV status, 6-min walk distance and haemodynamics were assessed at baseline, after 4 months and every 6-12 months thereafter. After 4 months, 6-min walk distance increased from 358+/-98 to 435+/-89 m and pulmonary vascular resistance decreased from 737+/-328 to 476+/-302 dyn x s x cm(-5). At the final evaluation (29+/-15 months), 6-min walk distance remained stable and pulmonary vascular resistance decreased further to 444+/-356 dyn x s x cm(-5). Haemodynamics normalised in 10 patients. At their last evaluation, these 10 patients were in WHO functional class I, with a 6-min walk distance of 532+/-52 m. Overall survival estimates were 93, 86 and 66% at 1, 2 and 3 yrs, respectively. Bosentan was safe when combined with highly active antiretroviral therapy, with no negative impact on HIV infection control. The present data confirm the long-term benefits of bosentan therapy in HIV-associated pulmonary arterial hypertension patients with improvements in symptoms, 6-min walk distance and haemodynamics, and with favourable overall survival.

• Authors: B Degano, A Yaïci, J Le Pavec, L Savale, X Jaïs, B Camara, M Humbert, G Simonneau, O Sitbon
• Journal: The European respiratory journal (Eur Respir J) Vol. 33 Issue 1 Pg. 92-8 (Jan 2009) ISSN: 1399-3003 [Electronic] England
• PMID: 18799506 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antihypertensive Agents
• Sulfonamides
• Bosentan

Topics

• Adult
• Antihypertensive Agents (administration & dosage)
• Antiretroviral Therapy, Highly Active
• Bosentan
• Cohort Studies
• Disease-Free Survival
• Drug Administration Schedule
• Exercise Tolerance
• Female
• HIV Infections (complications, drug therapy, physiopathology)
• Humans
• Hypertension, Pulmonary (drug therapy, physiopathology, virology)
• Male
• Middle Aged
• Retrospective Studies
• Sulfonamides (administration & dosage)
• Treatment Outcome