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Long-term inhaled iloprost use in children with pulmonary arterial hypertension

Published online by Cambridge University Press:  09 November 2011

Dursun Alehan ,
Işıl Yıldırım ,
Murat Şahin ,
Süheyla Özkutlu ,
Sema Özer  and
Tevfik Karagöz
Dursun Alehan*
Affiliation:
Section of Cardiology, Faculty of Medicine, Department of Pediatrics, Hacettepe University, Sıhhıye, Ankara, Turkey
Işıl Yıldırım
Affiliation:
Section of Cardiology, Faculty of Medicine, Department of Pediatrics, Hacettepe University, Sıhhıye, Ankara, Turkey
Murat Şahin
Affiliation:
Section of Cardiology, Faculty of Medicine, Department of Pediatrics, Hacettepe University, Sıhhıye, Ankara, Turkey
Süheyla Özkutlu
Affiliation:
Section of Cardiology, Faculty of Medicine, Department of Pediatrics, Hacettepe University, Sıhhıye, Ankara, Turkey
Sema Özer
Affiliation:
Section of Cardiology, Faculty of Medicine, Department of Pediatrics, Hacettepe University, Sıhhıye, Ankara, Turkey
Tevfik Karagöz
Affiliation:
Section of Cardiology, Faculty of Medicine, Department of Pediatrics, Hacettepe University, Sıhhıye, Ankara, Turkey
*
Correspondence to: Dr D. Alehan, MD, Section of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Sıhhıye, Ankara 06100, Turkey. Tel: +90 312 305 1157; Fax: +90 312 309 0220; E-mail: dalehan@hacettepe.edu.tr
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Abstract

Background

We performed a retrospective analysis of patients with pulmonary arterial hypertension receiving inhaled iloprost in a single centre to evaluate long-term tolerability, safety, and efficacy of chronic inhaled iloprost therapy in children.

Methods

A total of 20 patients with either idiopathic or associated pulmonary arterial hypertension were treated with iloprost between April, 2003 and January, 2010. The median age and weight of the patients were 3.8 years – ranging from 4 months to 19 years – and 12.3 kilograms – ranging from 4 to 73 kilograms – respectively. Pulmonary arterial hypertension was idiopathic or hereditary in eight patients (40%) and associated with congenital cardiac disease in 12 patients (60%).

Results

Of the 20 patients, 15 had combined therapy – 12 patients with two and three patients with three different classes of drugs. In all, six patients died during follow-up. The median follow-up time was 18 months, ranging from 6 to 74 months. The 6-minute walking test was performed in 7 out of 20 patients at baseline and on follow-up. The median 6-minute walking test increased from 420 to 490 metres after iloprost therapy (p = 0.028). After initiation of iloprost therapy, one patient complained of headache and another had a rash around his mouth, none necessitating discontinuation of therapy. Overall compliance with inhaled iloprost was good.

Conclusion

Pulmonary hypertension is associated with significant morbidity and mortality. Careful assessment of each patient and timely combination of specific vasodilator therapy is needed to improve clinical outcomes. This study suggests that inhaled iloprost, with or without concomitant endotelin receptor antagonist and/or phosphodiesterase inhibitor, is safe and efficacious for treatment of pulmonary arterial hypertension in children.

Keywords

Inhaled iloprostchildrenpulmonary arterial hypertension
Type
Original Article
Information
Cardiology in the Young , Volume 22 , Issue 4 , August 2012 , pp. 396 - 403
Copyright
Copyright © Cambridge University Press 2012

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