The Anatolian Journal of Cardiology
Original Investigation

Clinical efficacy, safety, tolerability, and survival outcome of long-term inhaled iloprost treatment in the management of pulmonary arterial hypertension: Data from prospective multicenter observational OPTION study

1.

Department of Cardiology, Institute of Cardiology, İstanbul University; İstanbul-Turkey

2.

Department of Chest Diseases, Cukurova University Faculty of Medicine, Adana, Turkey

3.

Department of Cardiology, Faculty of Medicine, Dokuz Eylül University; İzmir-Turkey

4.

Department of Cardiology, Faculty of Medicine, Uludağ University; Bursa-Turkey

5.

Department of Chest Diseases, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey

6.

Department of Cardiology, Ankara University Faculty of Medicine, Ankara, Turkey

7.

Department of Chest Diseases, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey

8.

Departments of Chest Diseases, Faculty of Medicine, Ankara University; Ankara-Turkey

9.

Department of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey

10.

Department of Biostatistics, Faculty of Medicine, Koç University; İstanbul-Turkey

Anatol J Cardiol 2021; 25: 721-732
DOI: 10.5152/AnatolJCardiol.2021.03009
Read: 313 Downloads: 143 Published: 01 October 2021

Objective: To evaluate clinical efficacy, safety and tolerability of long-term inhaled iloprost treatment in the daily practice for the management of pulmonary arterial hypertension (PAH).

Methods: A total of 115 patients with PAH on inhaled iloprost treatment were included. New York Heart Association (NYHA) functional class, brain natriuretic peptide (BNP) and N-terminal pro–B-type natriuretic peptide (NT-proBNP) levels, and 6-minute walk distance (6MWD) were recorded at baseline and at 3rd to 24th month visits. Safety and tolerability of iloprost treatment were also evaluated during follow-up, as were the survival, clinical worsening, and the related risk factors.

Results: The treatment was associated with an increase in the percentage NYHA functional class II (from 0.0% at enrolment to 36.2% at 24th month visit) patients but no significant difference was noted in 6MWD values. Clinical worsening was observed in 63.5% patients, while survival rate was 69.6%. NT-proBNP levels were significantly higher in non-survivors than in survivors (p=0.042). Cox regression analysis revealed the association of female sex [odds ratio (OR)=0.318; 95% confidence interval (CI), 0.128-0.792; p=0.014] and scleroderma-related PAH (OR=0.347; 95% CI, 0.140-0.860; p=0.022) with significantly lower risk (3.14 fold and 2.88 fold, respectively) of mortality.

Conclusion: Our findings indicate favorable efficacy, safety, and tolerability of long-term iloprost treatment in the management of PAH, whereas improved NYHA functional class was not accompanied with a significant change in 6MWD values. Patient age was a risk factor for clinical worsening, while female sex, scleroderma subtype, and lower NT-proBNP levels were associated with significantly lower mortality risk.

Cite this article as: Küçükoğlu MS, Hanta İ, Akdeniz B, Güllülü S, Atahan E, Sayın T, et al. Clinical efficacy, safety, tolerability, and survival outcome of long-term inhaled iloprost treatment in the management of pulmonary arterial hypertension: Data from prospective multicenter observational OPTION study. Anatol J Cardiol 2021; 25: 721-32.

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ISSN 2149-2263 EISSN 2149-2271