Chest
Clinical InvestigationsPulmonary HypertensionClinical Efficacy of Sitaxsentan, an Endothelin-A Receptor Antagonist, in Patients With Pulmonary Arterial Hypertension: Open-Label Pilot Study
Section snippets
Patient Selection
After institutional review board approval was obtained and informed consent signed, 6 children and 14 adults with primary pulmonary hypertension or PAH associated with either congenital systemic-to-pulmonary shunts or collagen vascular disease were enrolled in this study. Inclusion criteria were: (1) NYHA functional class II, III, or IV; (2) mean pulmonary artery pressure (PAPm) ≥ 25 mm Hg at rest, mean pulmonary capillary wedge pressure or left ventricular end-diastolic pressure ≤ 15 mm Hg,
Baseline Characteristics
The baseline demographic and hemodynamic characteristics are shown in Table 1. Six children and 14 adults were enrolled; 8 patients had primary pulmonary hypertension and 12 patients had PAH associated with either congenital systemic-to- pulmonary shunts (n = 10) or collagen vascular disease (n = 2). Fourteen patients were female and 6 patients were male. Mean ( ± SD) age was 36 ± 21 years (range, 7 to 68 years), and mean weight was 59 ± 19 kg (range, 25 to 87 kg).
Exercise Capacity
Despite a wide range of
Discussion
Sitaxsentan, a selective ET-A receptor antagonist, improved exercise capacity and cardiopulmonary hemodynamics in children and adults with PAH. In contrast to previous experience with epoprostenol,5,6,7,8 which has its greatest effect on cardiac output, sitaxsentan appears to have a greater effect on lowering pulmonary artery pressure than its effect on cardiac output. In contrast, similar to the experience with epoprostenol, the data from the first PAH bosentan trial also showed a greater
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Support was provided by the National Institutes of Health, National Center for Research Resources (RR-00645); Texas Biotechnology Corporation, Houston, TX; and ICOS Corporation, Bothell, WA.