Back to Journals » Vascular Health and Risk Management » Volume 5

Inhaled iloprost for the control of pulmonary hypertension

Authors Krug S, Sablotzki A, Hammerschmidt S, Wirtz H, Seyfarth H

Published 19 May 2009 Volume 2009:5 Pages 465—473

DOI https://doi.org/10.2147/VHRM.S3223

Review by Single-blind

Peer reviewer comments 4


Sabine Krug1, Armin Sablotzki2, Stefan Hammerschmidt1, Hubert Wirtz1, Hans-Juergen Seyfarth1

1University of Leipzig, Department of Respiratory Medicine, Germany; 2Klinikum St. Georg Leipzig, Clinics of Anaesthesiology, Critical Care and Pain Therapy, Germany

Abstract: Pulmonary arterial hypertension (PAH) is a life-threatening disease characterized by an elevated pulmonary arterial pressure and vascular resistance with a poor prognosis. Various pulmonary and extrapulmonary causes are now recognized to exist separately from the idiopathic form of pulmonary hypertension. An imbalance in the presence of vasoconstrictors and vasodilators plays an important role in the pathophysiology of the disease, one example being the lack of prostacyclin. Prostacyclin and its analogues are potent vasodilators with antithrombotic, antiproliferative and anti-inflammatory qualities, all of which are important factors in the pathogenesis of precapillary pulmonary hypertension. Iloprost is a stable prostacyclin analogue available for intravenous and aerosolized application. Due to the severe side effects of intravenous administration, the use of inhaled iloprost has become a mainstay in PAH therapy. However, owing to the necessity for 6 to 9 inhalations a day, oral treatment is often preferred as a first-line therapy. Numerous studies proving the efficacy and safety of inhaled iloprost have been performed. It is therefore available for a first-line therapy for PAH. The combination with endothelin-receptor antagonists or sildenafil has shown encouraging effects. Further studies with larger patient populations will have to demonstrate the use of combination therapy for long-term treatment of pulmonary hypertension.

Keywords: pulmonary arterial hypertension, prostacyclin, iloprost, inhaled

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]