Table 5.
Drug Class | Author (year) | Number of Participants | PH Definition | Lung Disease | Treatment | Duration | Primary Outcome | Result |
---|---|---|---|---|---|---|---|---|
ERA | Stolz et al246 (2008) | 30 | Echo PASP ≥ 30mmHg | COPD | Bosentan 125mg BID | 12 weeks | Change in 6MWD | No difference |
Valerio et al247 (2009) | 32 | RHC mPAP ≥ 25mmHg | COPD | Bosentan 125mg BID | 18 months | PFTs, hemodynamics, 6MWD, dyspnea ratings/quality of life | Improvement in mPAP, PVR, 6MWD, dyspnea ratings | |
Raghu et al195 (2013) | 492 | RHC mPAP ≥ 25mmHg | ILD | Ambrisentan 10mg daily | 16 weeks | Time to ILD progression | No difference; stopped early due to increased adverse events | |
Corte et al194 (2014) | 60 | RHC mPAP ≥ 25mmHg | ILD | Bosentan 125mg BID | 16 weeks | Decrease in PVRi from baseline ≥20% | No difference | |
PDE5 inhibitor | Collard et al248 (2007) | 11 | Echo PASP > 35mmHg or RHC mPAP ≥ 25mmHg | ILD | Sildenafil 20 – 50mg TID | 12 weeks | Change in 6MWD | Significant improvement |
Han et al198, 199 (2010) | 180 | N/A | ILD | Sildenafil 20mg TID | 12 weeks | 20% improvement in 6MWD | No difference except in subgroup with RV systolic dysfunction | |
Rao et al249 (2011) | 33 | Echo PASP > 40mmHg | COPD | Sildenafil 20mg TID | 12 weeks | Change in 6MWD | Significant improvement | |
Goudie et al196 (2014) | 120 | Echo PASP > 30mmHg or PA-AT < 120ms | COPD | Tadalafil 10mg daily | 12 weeks | Change in 6MWD | No difference | |
Vitulo et al197 (2017) | 28 | RHC mPAP ≥ 35mmHg and post-bronchodilator FEV1 < 30% or mPAP ≥ 30mmHg and post-bronchodilator FEV1 > 30% | COPD | Sildenafil 20mg TID | 16 weeks | Reduction in PVR | Significant improvement | |
Behr et al200 (2021) | 177 | RHC mPAP ≥ 20mmHg | ILD | Sildenafil 20mg TID + Pirfenidone 801mg TID | 52 weeks | Disease progression | No difference | |
Prostacyclin analogue | Saggar et al202 (2014) | 15 | RHC mPAP ≥ 35mmHg | ILD | Treprostinil 34 ± 21ng/kg/min | 12 weeks | Hemodynamics, 6MWD, PFTs, ECHO, dyspnea ratings/quality of life | Improvement in hemodynamics, 6MWD, dyspnea ratings |
Waxman et al56, 203 (2021) | 326 | RHC mPAP ≥ 25mmHg | ILD | Treprostinil 72 μg QID | 16 weeks | Change in 6MWD | Significant improvement; Improvement in FVC in IPF subgroup | |
sGC stimulator | Nathan et al201 (2019) | 147 | RHC mPAP ≥ 25mmHg | ILD | Riociguat 0.5 – 2.5mg TID | 26 weeks | Change in 6MWD | No difference; stopped early due to increased adverse events |
PH = pulmonary hypertension. ERA = endothelin receptor antagonist. RHC = right heart catheterization. mPAP = mean pulmonary artery pressure. ILD = interstitial lung disease. BID = two times per day. PVRi = pulmonary vascular resistance index. PVR = pulmonary vascular resistance. PFT = pulmonary function test. 6MWD = 6 minute walk distance. ECHO = echocardiogram. PDE5 = phosphodiesterase type-5. PASP = pulmonary artery systolic pressure. TID = three times per day. PA-AT = pulmonary artery acceleration time. FEV1 = forced expiratory volume in the first second. QID = four times per day. sGC = soluble guanyl cyclase.