Quality of Life in Pulmonary Arterial Hypertension: Improvement and Maintenance With Bosentan

• Published in: The Journal of heart and lung transplantation Vol. 26; no. 2; pp. 181 - 187
• Main Authors: Keogh, Anne M., MD, McNeil, Keith D., MD, Wlodarczyk, John, MD, Gabbay, Eli, MD, Williams, Trevor J., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-02-2007; Elsevier Science
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antihypertensive Agents - therapeutic use; Biological and medical sciences; Female; Humans; Hypertension, Pulmonary - drug therapy; Male; Medical sciences; Middle Aged; Pneumology; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases; Quality of Life; Sulfonamides - therapeutic use; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Heart; Human; Respiratory disease; Cardiovascular disease; Maintenance; Artery; Pulmonary hypertension; Quality of life; Improvement; Bosentan; Treatment; Surgery; Peptidergic receptor; Antagonist; Endothelin receptor
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2006.11.009

Background Bosentan (an oral dual endothelin receptor antagonist) improves symptoms and cardiac hemodynamics and reduces clinical worsening in patients with pulmonary arterial hypertension (PAH). The VITAL study assessed the effect of bosentan on quality of life in patients with WHO Functional Class III or IV PAH (idiopathic or associated with connective tissue diseases). Methods Quality of life was assessed prospectively using the MOS SF-36 and AQOL questionnaires. Baseline readings and scores at 3 and 6 months were collected, in addition to other efficacy and safety data. Results Among the 177 study patients, SF-36 scores were significantly improved at 3 months in the domains of physical functioning (27.3 to 34.8; p < 0.0001), role-physical (16.6 to 30.9; p < 0.0001), vitality (35.2 to 41.1; p = 0.0003), social functioning (48.0 to 58.6; p < 0.0001), mental health (64.2 to 72.0; p = 0.005) and role-emotional (44.8 to 58.1; p = 0.001). Improvements were seen in all etiologic sub-groups and were maintained in patients who remained on bosentan. An improvement in AQOL measures at 3 months was also noted for patients with baseline WHO Functional Class III. Conclusions Bosentan significantly improves quality of life in patients with idiopathic PAH or PAH associated with connective tissue diseases.