The Pharmaceutical Journal
Vol 269 No 7214 p314
7 September 2002

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New England Journal of Medicine (content.nejm.org)

Prostacyclin analogue effective for pulmonary hypertension

Inhaled iloprost (Ilomedin), a stable prostacyclin analogue, is an effective therapy for patients with severe pulmonary hypertension, researchers say.

Dr Horst Olschewski, University Clinic, Giessen, Germany, and colleagues compared repeated daily inhalations of iloprost with inhalation of placebo in 203 patients with selected forms of severe pulmonary hypertension and chronic thromboembolic pulmonary hypertension.

They found that a combined end point, consisting of an increase of at least 10 per cent in the distance walked in six minutes and a reduction in the severity of heart failure in the absence of a deterioration in the clinical condition, was met, at 12 weeks, by 16.8 per cent of patients in the iloprost group, compared with 4.9 per cent of patients in the placebo group. However, they comment that a substantial number of the remaining patients met less strict criteria for clinical improvement.

The researchers conclude that inhaled iloprost "may be a suitable alternative to continuous intravenous prostacyclin, especially in patients who do not derive a clear survival benefit with intravenous therapy". The study is published in The New England Journal of Medicine (2002;347:322).

Schering Health Care, manufacturer of iloprost, says that it is applying for a licence for iloprost for the treatment of pulmonary hypertension, but does not yet know when the licence will be granted. Iloprost is currently available in the United Kingdom for use on a named-patient basis for peripheral vascular disease, including Raynaud's syndrome and scleroderma.