Combination of bosentan with epoprostenol in pulmonary arterial hypertension: BREATHE-2

doi:10.1183/09031936.04.00028404

Paper

Combination of bosentan with epoprostenol in pulmonary arterial hypertension: BREATHE-2

Published Sep 1, 2004 · M. Humbert, R. Barst, I. Robbins

European Respiratory Journal

Q1 SJR score

645

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23

Influential Citations

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Abstract

The efficacy and safety of combining bosentan, an orally active dual endothelin receptor antagonist and epoprostenol, a continuously infused prostaglandin, in the treatment of pulmonary arterial hypertension (PAH) was investigated. In this double-blind, placebo-controlled prospective study, 33 patients with PAH started epoprostenol treatment (2 ng·kg−1min−1 starting dose, up to 14±2 ng·kg−1min−1 at week 16) and were randomised for 16 weeks in a 2:1 ratio to bosentan (62.5 mg b.i.d for 4 weeks then 125 mg b.i.d) or placebo. Haemodynamics, exercise capacity and functional class improved in both groups at week 16. In the combination treatment group, there was a trend for a greater (although nonsignificant) improvement in all measured haemodynamic parameters. There were four withdrawals in the bosentan/epoprostenol group (two deaths due to cardiopulmonary failure, one clinical worsening, and one adverse event) and one withdrawal in the placebo/epoprostenol group (adverse event). This study showed a trend but no statistical significance towards haemodynamics or clinical improvement due to the combination of bosentan and epoprostenol therapy in patients with pulmonary arterial hypertension. Several cases of early and late major complications were reported. Additional information is needed to evaluate the risk/benefit ratio of combined bosentan-epoprostenol therapy in pulmonary arterial hypertension.

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Study Snapshot

Combining bosentan and epoprostenol shows a trend for nonsignificant improvement in haemodynamics and clinical improvement in pulmonary arterial hypertension patients, but potential risks require further evaluation.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

Paper

Combination of bosentan with epoprostenol in pulmonary arterial hypertension: BREATHE-2

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Citations

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Statement of intent

The new communications campaign expanded recycling opportunities in the downtown area and integrated public education and media relations for residential curbside customers.

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