Abstract

WILLS, Beatriz  and  BUITRAGO, Andres F. New agents for the treatment of pulmonary hypertension. Rev. Colomb. Cardiol. [online]. 2014, vol.21, n.6, pp.399-408. ISSN 0120-5633.  https://doi.org/10.1016/j.rccar.2014.05.007.

Pulmonary hypertension is a complex disorder that requires a multidisciplinary approach. Recent medical advances have led to the recognition of new therapies that offer management alternatives as concluded from clinical studies published in the past year. This topic review discusses the clinical trials that led to approval of new drugs for the management of pulmonary hypertension. Two phase three trials showed that riociguat, a stimulator of soluble guanylate cyclase, significantly improved exercise capacity, pulmonary vascular resistance, NT-proBNP levels and functional class both in patients with thromboembolic pulmonary hypertension without indication of surgical treatment and in symptomatic pulmonary arterial hypertension patients who were receiving endothelin receptor antagonists or prostanoids. Macitentan, a dual endothelin receptor antagonist reduced morbidity and mortality in a dose dependent manner in patients with hypertension in a period of 3.5 years. The results of these investigations offer an alternative therapeutic approach to pulmonary arterial hypertension as outlined in the new guidelines for pulmonary hypertension performed in Nice, France published in 2013. It is still necessary to conduct new clinical trials comparing these new molecules with the treatment that is currently recommended.

Keywords : Pulmonary hypertension; Nitric oxide; Endothelin; Pulmonary thromboembolism.

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