Clinical efficacy and survival with first-line inhaled iloprost therapy in patients with idiopathic pulmonary arterial hypertension

Christian F. Opitz, Roland Wensel, Jörg Winkler, Michael Halank, Leonhard Bruch, Franz Xaver Kleber, Gert Höffken, Stefan D. Anker, Abdissa Negassa, Stephan B. Felix, Roland Hetzer, Ralf Ewert

Research output: Contribution to journalArticle

141 Citations (Scopus)

Abstract

Aims: To describe the long-term clinical efficacy of inhaled iloprost as first-line vasodilator mono-therapy in patients with idiopathic pulmonary arterial hypertension (IPAH). Methods and results: Seventy-six IPAH patients were prospectively identified and treated with inhaled iloprost. Clinical, haemodynamic, and exercise parameters were obtained at baseline, after 3 and 12 months of therapy and yearly thereafter. Four endpoints were prospectively defined as follows: (i) death, (ii) transplantation, (iii) switch to intravenous (i.v.) therapy, or (iv) addition of or switch to other active oral therapy. During follow-up (535 ± 61 days), 11 patients died, six were transplanted, 25 were switched to i.v. prostanoids, 16 received additional or other oral therapy, and 12 patients discontinued iloprost inhalation for other reasons. Event-free survival at 3, 12, 24, 36, 48, and 60 months was 81, 53, 29, 20, 17 and 13%, respectively. Among haemodynamic and exercise parameters, mixed venous oxygen saturation (P <0.001), right atrial pressure (P <0.001), and peak oxygen uptake (P = 0.002) were associated with event-free survival. Conclusion: In this study, only a minority of patients could be stabilized with inhaled iloprost monotherapy during a follow-up period of up to 5 years. In the presence of multiple treatment options, chronic iloprost inhalation as mono-therapy appears to have a limited role.

Original languageEnglish
Pages (from-to)1895-1902
Number of pages8
JournalEuropean Heart Journal
Volume26
Issue number18
DOIs
Publication statusPublished - Sep 2005

Fingerprint

Iloprost
Survival
Inhalation
Therapeutics
Disease-Free Survival
Hemodynamics
Exercise
Oxygen
Atrial Pressure
Familial Primary Pulmonary Hypertension
Vasodilator Agents
Prostaglandins
Transplantation

Keywords

  • Chronic therapy
  • Inhaled iloprost
  • Pulmonary arterial hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Clinical efficacy and survival with first-line inhaled iloprost therapy in patients with idiopathic pulmonary arterial hypertension. / Opitz, Christian F.; Wensel, Roland; Winkler, Jörg; Halank, Michael; Bruch, Leonhard; Kleber, Franz Xaver; Höffken, Gert; Anker, Stefan D.; Negassa, Abdissa; Felix, Stephan B.; Hetzer, Roland; Ewert, Ralf.

In: European Heart Journal, Vol. 26, No. 18, 09.2005, p. 1895-1902.

Research output: Contribution to journalArticle

Opitz, CF, Wensel, R, Winkler, J, Halank, M, Bruch, L, Kleber, FX, Höffken, G, Anker, SD, Negassa, A, Felix, SB, Hetzer, R & Ewert, R 2005, 'Clinical efficacy and survival with first-line inhaled iloprost therapy in patients with idiopathic pulmonary arterial hypertension', European Heart Journal, vol. 26, no. 18, pp. 1895-1902. https://doi.org/10.1093/eurheartj/ehi283
Opitz, Christian F. ; Wensel, Roland ; Winkler, Jörg ; Halank, Michael ; Bruch, Leonhard ; Kleber, Franz Xaver ; Höffken, Gert ; Anker, Stefan D. ; Negassa, Abdissa ; Felix, Stephan B. ; Hetzer, Roland ; Ewert, Ralf. / Clinical efficacy and survival with first-line inhaled iloprost therapy in patients with idiopathic pulmonary arterial hypertension. In: European Heart Journal. 2005 ; Vol. 26, No. 18. pp. 1895-1902.
@article{48708828d69d43d28c828374f82b4619,
title = "Clinical efficacy and survival with first-line inhaled iloprost therapy in patients with idiopathic pulmonary arterial hypertension",
abstract = "Aims: To describe the long-term clinical efficacy of inhaled iloprost as first-line vasodilator mono-therapy in patients with idiopathic pulmonary arterial hypertension (IPAH). Methods and results: Seventy-six IPAH patients were prospectively identified and treated with inhaled iloprost. Clinical, haemodynamic, and exercise parameters were obtained at baseline, after 3 and 12 months of therapy and yearly thereafter. Four endpoints were prospectively defined as follows: (i) death, (ii) transplantation, (iii) switch to intravenous (i.v.) therapy, or (iv) addition of or switch to other active oral therapy. During follow-up (535 ± 61 days), 11 patients died, six were transplanted, 25 were switched to i.v. prostanoids, 16 received additional or other oral therapy, and 12 patients discontinued iloprost inhalation for other reasons. Event-free survival at 3, 12, 24, 36, 48, and 60 months was 81, 53, 29, 20, 17 and 13{\%}, respectively. Among haemodynamic and exercise parameters, mixed venous oxygen saturation (P <0.001), right atrial pressure (P <0.001), and peak oxygen uptake (P = 0.002) were associated with event-free survival. Conclusion: In this study, only a minority of patients could be stabilized with inhaled iloprost monotherapy during a follow-up period of up to 5 years. In the presence of multiple treatment options, chronic iloprost inhalation as mono-therapy appears to have a limited role.",
keywords = "Chronic therapy, Inhaled iloprost, Pulmonary arterial hypertension",
author = "Opitz, {Christian F.} and Roland Wensel and J{\"o}rg Winkler and Michael Halank and Leonhard Bruch and Kleber, {Franz Xaver} and Gert H{\"o}ffken and Anker, {Stefan D.} and Abdissa Negassa and Felix, {Stephan B.} and Roland Hetzer and Ralf Ewert",
year = "2005",
month = "9",
doi = "10.1093/eurheartj/ehi283",
language = "English",
volume = "26",
pages = "1895--1902",
journal = "European Heart Journal",
issn = "0195-668X",
publisher = "Oxford University Press",
number = "18",

}

TY - JOUR

T1 - Clinical efficacy and survival with first-line inhaled iloprost therapy in patients with idiopathic pulmonary arterial hypertension

AU - Opitz, Christian F.

AU - Wensel, Roland

AU - Winkler, Jörg

AU - Halank, Michael

AU - Bruch, Leonhard

AU - Kleber, Franz Xaver

AU - Höffken, Gert

AU - Anker, Stefan D.

AU - Negassa, Abdissa

AU - Felix, Stephan B.

AU - Hetzer, Roland

AU - Ewert, Ralf

PY - 2005/9

Y1 - 2005/9

N2 - Aims: To describe the long-term clinical efficacy of inhaled iloprost as first-line vasodilator mono-therapy in patients with idiopathic pulmonary arterial hypertension (IPAH). Methods and results: Seventy-six IPAH patients were prospectively identified and treated with inhaled iloprost. Clinical, haemodynamic, and exercise parameters were obtained at baseline, after 3 and 12 months of therapy and yearly thereafter. Four endpoints were prospectively defined as follows: (i) death, (ii) transplantation, (iii) switch to intravenous (i.v.) therapy, or (iv) addition of or switch to other active oral therapy. During follow-up (535 ± 61 days), 11 patients died, six were transplanted, 25 were switched to i.v. prostanoids, 16 received additional or other oral therapy, and 12 patients discontinued iloprost inhalation for other reasons. Event-free survival at 3, 12, 24, 36, 48, and 60 months was 81, 53, 29, 20, 17 and 13%, respectively. Among haemodynamic and exercise parameters, mixed venous oxygen saturation (P <0.001), right atrial pressure (P <0.001), and peak oxygen uptake (P = 0.002) were associated with event-free survival. Conclusion: In this study, only a minority of patients could be stabilized with inhaled iloprost monotherapy during a follow-up period of up to 5 years. In the presence of multiple treatment options, chronic iloprost inhalation as mono-therapy appears to have a limited role.

AB - Aims: To describe the long-term clinical efficacy of inhaled iloprost as first-line vasodilator mono-therapy in patients with idiopathic pulmonary arterial hypertension (IPAH). Methods and results: Seventy-six IPAH patients were prospectively identified and treated with inhaled iloprost. Clinical, haemodynamic, and exercise parameters were obtained at baseline, after 3 and 12 months of therapy and yearly thereafter. Four endpoints were prospectively defined as follows: (i) death, (ii) transplantation, (iii) switch to intravenous (i.v.) therapy, or (iv) addition of or switch to other active oral therapy. During follow-up (535 ± 61 days), 11 patients died, six were transplanted, 25 were switched to i.v. prostanoids, 16 received additional or other oral therapy, and 12 patients discontinued iloprost inhalation for other reasons. Event-free survival at 3, 12, 24, 36, 48, and 60 months was 81, 53, 29, 20, 17 and 13%, respectively. Among haemodynamic and exercise parameters, mixed venous oxygen saturation (P <0.001), right atrial pressure (P <0.001), and peak oxygen uptake (P = 0.002) were associated with event-free survival. Conclusion: In this study, only a minority of patients could be stabilized with inhaled iloprost monotherapy during a follow-up period of up to 5 years. In the presence of multiple treatment options, chronic iloprost inhalation as mono-therapy appears to have a limited role.

KW - Chronic therapy

KW - Inhaled iloprost

KW - Pulmonary arterial hypertension

UR - http://www.scopus.com/inward/record.url?scp=21544449424&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=21544449424&partnerID=8YFLogxK

U2 - 10.1093/eurheartj/ehi283

DO - 10.1093/eurheartj/ehi283

M3 - Article

C2 - 15888496

AN - SCOPUS:21544449424

VL - 26

SP - 1895

EP - 1902

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 18

ER -