Back to Browse Journals » Vascular Health and Risk Management » Volume 7

Effect of transition from sitaxsentan to ambrisentan in pulmonary arterial hypertension

Authors Zeenat Safdar

Published 2 March 2011 Volume 2011:7 Pages 119—124

DOI https://dx.doi.org/10.2147/VHRM.S15026

Review by Single-blind

Peer reviewer comments 2

Zeenat Safdar
Division of Pulmonary-Critical Care Medicine, Baylor College of Medicine, Houston, Texas, USA

Introduction: Currently available endothelin receptor antagonists for treating pulmonary arterial hypertension block either the endothelin (ET) receptor A or both A and B receptors. Transition from one endothelin receptor antagonist to another may theoretically alter side-effects or efficacy. We report our experience of a transition from sitaxsentan to ambrisentan, both predominant ETA receptor antagonists, in pulmonary arterial hypertension patients.
Methods: At Baylor Pulmonary Hypertension Center, 18 patients enrolled in the open-label extension phase of the original sitaxsentan studies (Sitaxsentan To Relieve ImpaireD Exercise) were transitioned to ambrisentan (from July 2007 to September 2007) at the time of study closure. Pre-transition (PreT), 1 month (1Mth) and 1 year (1Yr) post-transition assessments of 6-minute walk distance (6MWD), brain naturetic peptide (BNP) levels, WHO functional class (WHO FC), Borg dyspnea score (BDS), oxygen saturation, liver function, and peripheral edema were compared.
Results: 6MWD was 356 ± 126 m at PreT, 361 ± 125 m at 1Mth, and 394 ± 114 m at 1Yr (mean ± SD). There was no difference in the walk distance at 1Mth and 1Yr post transition compared with PreT (P = 0.92, 0.41 respectively). Oxygen saturation was no different at 1Mth and 1Yr to PreT level (P = 0.49 and P = 0.06 respectively). BNP was 178 ± 244 pg/mL at PreT, 129 ± 144 pg/mL at 1Mth and 157 ± 201 at 1Yr. Peripheral edema was present in 7/18 patients at PreT, in 8/16 patients at 1Mth, and in 6/13 patients at 1Yr post transition. Proportions of patients with edema over these 3 time points did not change significantly (P = 0.803). At 1Yr, 2 patients had died, 1 had undergone lung transplantation, 1 had relocated, and 1 patient was started on intravenous prostacyclin therapy. Over 3 points (baseline, 1 month, and 1 year), there was no significant change in function class (P = 0.672).
Conclusion: Our limited data suggest that ETA receptor antagonists can be switched from one to another with sustained exercise capacity and maintained WHO FC with no increase in incidence of peripheral edema.

Keywords: right heart failure, 6-minute walk distance, endothelial receptor antagonist, echocardiogram

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Readers of this article also read:

Optimal delivery of male breast cancer follow-up care: improving outcomes

Ferzoco RM, Ruddy KJ

Breast Cancer: Targets and Therapy 2015, 7:371-379

Published Date: 23 November 2015

Advances in cancer pain from bone metastasis

Zhu XC, Zhang JL, Ge CT, Yu YY, Wang P, Yuan TF, Fu CY

Drug Design, Development and Therapy 2015, 9:4239-4245

Published Date: 18 August 2015

The role of regulatory T cells in cancer immunology

Whiteside TL

ImmunoTargets and Therapy 2015, 4:159-171

Published Date: 5 August 2015

Critical evaluation of ramucirumab in the treatment of advanced gastric and gastroesophageal cancers

ElHalawani H, Abdel-Rahman O

Therapeutics and Clinical Risk Management 2015, 11:1123-1132

Published Date: 28 July 2015

Clinical utilities of aromatase inhibitors in breast cancer

Chumsri S

International Journal of Women's Health 2015, 7:493-499

Published Date: 6 May 2015

Update of research on the role of EZH2 in cancer progression

Shen L, Cui J, Liang S, Pang Y, Liu P

OncoTargets and Therapy 2013, 6:321-324

Published Date: 4 April 2013

Implications for breast cancer dormancy in other areas of medicine

Rameshwar P

Breast Cancer: Targets and Therapy 2012, 4:193-195

Published Date: 5 December 2012

Denosumab, a RANK ligand inhibitor, for the management of bone loss in cancer patients

Yee AJ, Raje NS

Clinical Interventions in Aging 2012, 7:331-338

Published Date: 3 September 2012

How to reduce your cancer risk: mechanisms and myths

Nahleh Z, Bhatti NS, Mal M

International Journal of General Medicine 2011, 4:277-287

Published Date: 8 April 2011

Capecitabine in the management of colorectal cancer

Hirsch BR, Zafar SY

Cancer Management and Research 2011, 3:79-89

Published Date: 24 March 2011