Long-term (5 years) effects of bosentan in patients with pulmonary arterial hypertension.

Abstract

INTRODUCTION AND OBJECTIVES:

Bosentan has proven efficacy in pulmonary hypertension in the short term. Little is known about its effects beyond 2 to 3 years. Our objective was to analyze the efficacy and safety of bosentan in the long term (5 years) in patients treated in our center.

METHODS:

This retrospective study sequentially analyzed clinical, functional, and laboratory parameters in a series of patients treated initially with bosentan as monotherapy from 2002 to 2009 in a single hospital. Treatment success was defined as survival without clinical worsening that required additional pulmonary vasodilators.

RESULTS:

We included 20 patients (70% women, mean age 46 ± 14 years, 65% congenital heart disease), with a median follow-up of 64 months. One patient required withdrawal of bosentan due to adverse effects. At 4 months, significant improvements were achieved in hemodynamic, clinical and functional parameters. Clinical and functional benefits persisted at 5-year follow-up. Overall 5-year survival after beginning bosentan therapy was 95% (84%-100%). Treatment success at 1, 2, 3, 4 and 5 years was 95% (84%-100%), 83% (65%-100%), 78% (58%-98%), 61% (38%-84%), and 41% (16%-66%), respectively. The group with better outcomes had NT-proBNP levels at 1 year <400 pg/mL (P=.013).

CONCLUSIONS:

In our series, treatment success with bosentan in monotherapy was maintained in 78% at 3-year follow-up and 41% at 5-year follow-up. The group with long-term success showed significantly lower NT-proBNP levels at 1-year follow-up. Survival at 5 years in our series was 95%.

• Authors: Patricia Avellana, Javier Segovia, Elena Sufrate, Manuel Gómez-Bueno, María Dolores García-Cosío Carmena, Pablo García-Pavía, Carlos Gutiérrez Landaluce, Elena Pérez Pereira, Luis Alonso-Pulpón
• Journal: Revista espanola de cardiologia (Rev Esp Cardiol) Vol. 64 Issue 8 Pg. 667-73 (Aug 2011) ISSN: 1579-2242 [Electronic] Spain
• PMID: 21719181 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Chemical References

• Antihypertensive Agents
• Sulfonamides
• Bosentan

Topics

• Antihypertensive Agents (therapeutic use)
• Bosentan
• Familial Primary Pulmonary Hypertension
• Female
• Humans
• Hypertension, Pulmonary (drug therapy)
• Male
• Middle Aged
• Retrospective Studies
• Sulfonamides (therapeutic use)
• Time Factors
• Treatment Outcome