Source: DGNews  |  Posted 2 years ago

By Betty S. Riggs

SAN DIEGO -- November 9, 2009 -- In patients with moderate to severe chronic
obstructive pulmonary disease (COPD) and pulmonary hypertension (PH), bosentan
plus best conventional care produced greater improvement in cardiovascular
parameters than best conventional care alone.

Pietro B. Bracciale, MD, Department of Respiratory Disease, San Pietro
Vernotico Hospital, Brindisi, Italy, reported the findings on November 3 here
at CHEST 2009, the annual meeting of the American College of Chest Physicians.

For the study, 40 patients with moderate to severe COPD and PH were treated
with best conventional care for 1 month, at which time they were reassessed.
Patients with persistent PH (not reversible during oxygen administration) were
randomised to receive placebo plus conventional treatment or to bosentan 125 mg
BID plus conventional care for 18 months.

Pulmonary function tests, Doppler echocardiography, right heart
catheterisation, 6-minute-walk test distance (6MWD), blood gas analysis, and
quality of life were assessed at the beginning and end of the study. Of the
patients, 32 completed the study (16 in each group).

After 18 months of treatment, there were significant changes from baseline in
the bosentan combination group but not in the conventional treatment group for
mean pulmonary artery pressure (P = .002 vs NS), mean pulmonary
vascular resistance (P = .0115 vs NS), distance on the 6MWD
(P = .0027 vs NS), World Health Organization Functional Class
(P = .05 vs NS), and the body mass index, airway obstruction,
dyspnoea, and exercise capacity index (P = .002 vs NS).

According to Dr. Bracciale, bosentan should be a useful early treatment for
patients affected by PH and moderate to severe COPD before pathologic vessel
changes have occurred. The beneficial effect of bosentan may be partially
linked to its vasodilating action and its effect on vascular remodelling.

Presentation title: Effect of Bosentan on the Progressive Worsening of
Pulmonary Vascular Remodelling and Pulmonary Hypertension Associated With
Moderate/Severe COPD: Results of 18 Months of Treatment