The Pharmaceutical Journal
Vol 270 No 7251 p742
31 May 2003

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Bosentan improves survival in pulmonary hypertension patients

First-line treatment with bosentan (Tracleer), a dual endothelin receptor antagonist, significantly improves three-year survival in patients with primary pulmonary hypertension (PPH), according to the first study to assess long-term survival with this drug.

The study was presented at the American Thoracic Society conference. Survival in patients treated with bosentan was higher (86 per cent) after three years follow-up than a predicted survival rate of 48 per cent from a United States registry of patients before specific treatments for PPH were developed.

The study showed that survival increased earlier in the bosentan group than in control patients (96 vs 69 per cent at one year) and was then maintained to three years. The differences between observed and predicted survival rates at six, 12, 24 and 36 months were all in favour of bosentan (P<0.001).

The results came from a retrospective analysis of 169 patients with PPH who took part in two randomised, double-blind, placebo-controlled trials, followed by open label extensions. All patients had severe PPH. Lead investigator Dr Vallerie McLaughlin, Rush-Presbyterian Medical Centre, Illinois, US, said: "Previous studies showed that treatment with bosentan improves symptoms and decreases the rate of clinical worsening. Now we have new evidence suggesting that first-line treatment with bosentan is associated with improved survival." She added: "Based on these findings, bosentan should be considered first-line therapy for most patients with PPH."

The Journal attended the American Thoracic Society's 99th international conference in Seattle, Washington, courtesy of GlaxoSmithKline