Prostanoids Terbogrel
Medical > Therapy > Specific treatments
Prostanoids
Terbogrel
Thromboxane A2, the vasoconstrictor, platelet aggregant, and smooth muscle mitogen, is elevated in patients with PAH (Christman et al. 1992) and may contribute to the progression of vascular narrowing. Therefore, the effects of a potent orally active thromboxane synthetase inhibitor and thromboxane receptor antagonist terbogrel was planned to be studied for 3 months in patients with PAH and NYHA class II and III (Langleben et al. 2002). Although the planned enrollment was 135 patients, the study was halted after only 71 patients had been randomized because of the unforeseen side effect of leg pain, which occurred almost exclusively in patients with terbogrel treatment. Only 52 patients completed the 12-week study, and only 22 patients (31 %) were fully compliant with the study medication. The leg pain confounded the primary endpoint of walking distance. On an intention-to-treat analysis, no improvements in 6-minute walk distance or in hemodynamics in patients with terbogrel treatment were seen. However, terbogrel was effective from a pharmacologic standpoint, reducing thromboxane metabolites by as much as 98 % (P <0.001), with a modest but statistically insignificant (39 %) rise in prostacyclin metabolites.
References
Back to > Medical > Therapy > Specific treatments
Prostanoids
Terbogrel
Thromboxane A2, the vasoconstrictor, platelet aggregant, and smooth muscle mitogen, is elevated in patients with PAH (Christman et al. 1992) and may contribute to the progression of vascular narrowing. Therefore, the effects of a potent orally active thromboxane synthetase inhibitor and thromboxane receptor antagonist terbogrel was planned to be studied for 3 months in patients with PAH and NYHA class II and III (Langleben et al. 2002). Although the planned enrollment was 135 patients, the study was halted after only 71 patients had been randomized because of the unforeseen side effect of leg pain, which occurred almost exclusively in patients with terbogrel treatment. Only 52 patients completed the 12-week study, and only 22 patients (31 %) were fully compliant with the study medication. The leg pain confounded the primary endpoint of walking distance. On an intention-to-treat analysis, no improvements in 6-minute walk distance or in hemodynamics in patients with terbogrel treatment were seen. However, terbogrel was effective from a pharmacologic standpoint, reducing thromboxane metabolites by as much as 98 % (P <0.001), with a modest but statistically insignificant (39 %) rise in prostacyclin metabolites.
References
Back to > Medical > Therapy > Specific treatments
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SSPH Research Prize 2012
Deadline for submission: April 30, 2012
Further information
Symposium "pulmonal-arterielle Hypertension im Kindesalter"
Donnerstag, 10. Mai 2012, 16.00-18.00, Bern
Further information:
5th International Congress of the Swiss Society of Pulmonary Hypertension (SSPH)
28.-29. September 2012, Thun, Congress Hotel Seepark Thun
Informationen: www.imk.ch/sgph2012
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