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Bosentan: a review of its use in pulmonary arterial hypertension and systemic sclerosis.
Am J Cardiovasc Drugs. 2006; 6(3):189-208.AJ

Abstract

Bosentan (Tracleer), an orally administered dual endothelin (ET)(A) and ET(B) receptor antagonist, is indicated in the treatment of pulmonary arterial hypertension (PAH). The efficacy of oral bosentan 125 mg twice daily in improving exercise capacity has been demonstrated in well designed trials in adult patients with idiopathic PAH or PAH associated with connective tissue disease or congenital systemic-to-pulmonary shunts, and in other trials in patients with idiopathic PAH or PAH associated with congenital heart disease or HIV infection. The beneficial effects of first-line bosentan treatment may be maintained for up to 1 year in patients with idiopathic PAH or PAH associated with connective tissue disease. Despite the potential for treatment-related teratogenicity and hepatotoxicity, long-term data indicate that bosentan is generally well tolerated at the approved dosages. Although well designed trials are required to establish the efficacy of bosentan versus or in combination with other specific PAH therapies, especially sildenafil, the convenient oral administration and lack of serious injection-related adverse effects may render bosentan preferable to other PAH therapies. Preliminary data indicate that bosentan may be effective in pediatric PAH patients, although randomized trials are required. Furthermore, bosentan may be a useful option for the prevention of digital ulcer development in patients with systemic sclerosis. Thus, in accordance with current clinical guidelines, bosentan is a convenient, effective, and generally well tolerated agent for use in the first-line treatment of class III PAH or second-line treatment of class IV PAH.

Authors+Show Affiliations

Adis International Inc., Yardley, Pennsylvania 19067, USA. demail@adis.comNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16780392

Citation

Oldfield, Vicki, and Katherine A. Lyseng-Williamson. "Bosentan: a Review of Its Use in Pulmonary Arterial Hypertension and Systemic Sclerosis." American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions, vol. 6, no. 3, 2006, pp. 189-208.
Oldfield V, Lyseng-Williamson KA. Bosentan: a review of its use in pulmonary arterial hypertension and systemic sclerosis. Am J Cardiovasc Drugs. 2006;6(3):189-208.
Oldfield, V., & Lyseng-Williamson, K. A. (2006). Bosentan: a review of its use in pulmonary arterial hypertension and systemic sclerosis. American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions, 6(3), 189-208.
Oldfield V, Lyseng-Williamson KA. Bosentan: a Review of Its Use in Pulmonary Arterial Hypertension and Systemic Sclerosis. Am J Cardiovasc Drugs. 2006;6(3):189-208. PubMed PMID: 16780392.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bosentan: a review of its use in pulmonary arterial hypertension and systemic sclerosis. AU - Oldfield,Vicki, AU - Lyseng-Williamson,Katherine A, PY - 2006/6/20/pubmed PY - 2006/12/9/medline PY - 2006/6/20/entrez SP - 189 EP - 208 JF - American journal of cardiovascular drugs : drugs, devices, and other interventions JO - Am J Cardiovasc Drugs VL - 6 IS - 3 N2 - Bosentan (Tracleer), an orally administered dual endothelin (ET)(A) and ET(B) receptor antagonist, is indicated in the treatment of pulmonary arterial hypertension (PAH). The efficacy of oral bosentan 125 mg twice daily in improving exercise capacity has been demonstrated in well designed trials in adult patients with idiopathic PAH or PAH associated with connective tissue disease or congenital systemic-to-pulmonary shunts, and in other trials in patients with idiopathic PAH or PAH associated with congenital heart disease or HIV infection. The beneficial effects of first-line bosentan treatment may be maintained for up to 1 year in patients with idiopathic PAH or PAH associated with connective tissue disease. Despite the potential for treatment-related teratogenicity and hepatotoxicity, long-term data indicate that bosentan is generally well tolerated at the approved dosages. Although well designed trials are required to establish the efficacy of bosentan versus or in combination with other specific PAH therapies, especially sildenafil, the convenient oral administration and lack of serious injection-related adverse effects may render bosentan preferable to other PAH therapies. Preliminary data indicate that bosentan may be effective in pediatric PAH patients, although randomized trials are required. Furthermore, bosentan may be a useful option for the prevention of digital ulcer development in patients with systemic sclerosis. Thus, in accordance with current clinical guidelines, bosentan is a convenient, effective, and generally well tolerated agent for use in the first-line treatment of class III PAH or second-line treatment of class IV PAH. SN - 1175-3277 UR - https://www.unboundmedicine.com/medline/citation/16780392/Bosentan:_a_review_of_its_use_in_pulmonary_arterial_hypertension_and_systemic_sclerosis_ L2 - https://dx.doi.org/10.2165/00129784-200606040-00001 DB - PRIME DP - Unbound Medicine ER -