Head-to-head pulmonary arterial hypertension trial
Treatment of pulmonary arterial hypertension (PAH) with the oral dual endothelin receptor antagonist bosentan (Tracleer) achieves a similar increase in survival as intravenous epoprostenol, according to a study presented at the American
Thoracic Society annual conference held in Orlando, Florida, last month.
The international study compared survival in patients treated with bosentan
as first-line therapy in two randomised trials and during open-label
extension studies (139 patients) with survival in patients treated with
first-line epoprostenol (346 patients). The estimated survival (analysed
as Kaplan-Meier estimates) was 97 per cent at one year and 91 per cent
at two years with bosentan, compared with 91 per cent and 84 per cent,
respectively, for epoprostenol. Reporting the findings, Olivier Sitbon,
Antoine-Beclere Hospital, Clamart, France, said: “Starting treatment
with bosentan rather than epoprostenol did not adversely affect outcomes
in patients with PAH.”
Roisín O’Hare, cardiology pharmacist at Royal Victoria Hospital,
Belfast, commented: “Bosentan is much easier for patients to use.
IV epoprostenol has to be made up every 12 hours and to be given by a
central Hickman catheter, requiring a great deal of education for patients
and their families. Knowing that we can give bosentan — which is
a twice-daily oral therapy — and achieve similar survival is encouraging,
knowing that compliance will be better.”
A further study from the US reported at the meeting indicated that bosentan
improved survival in children with PAH. Both studies were funded by Actelion,
the company that developed bosentan. |
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