This is an open label, randomized, interventional study indented to find the efficacy of different treatment regimens in treatment of pulmonary hypertension secondary to lung disease and/or hypoxia.This is to find out when to start combination therapy (sildenafil plus bosentan) in treatment of pulmonary hypertension secondary to lung disease and/or hypoxia.
This is an open label, randomized, interventional study indented to find the efficacy of different treatment regimens in treatment of pulmonary hypertension secondary to lung disease and/or hypoxia. It involves 3 arms, one getting monotherapy with sildenafil for 6 months, 2nd getting bosentan monotherapy initially for 3 months and then combination of sildenafil and bosentan for 3 months, 3rd getting combination sildenafil and bosentan from the beginning for 6 months. The aim is to decide when is the best time to start combination therapy either from start or at the time of drug failure. Improvement will be assessed by change in functional class, pulmonary pressures measured by ECHO, pulmonary function test, six minute walk test and biochemical markers. Lack of randomized trials and Indian data is there on the subject. Also adverse events and serious adverse events will be closely monitored and reported to the ethics committee and DCGI immediately.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
20 mg initially and then increased to 20 mg TDS if there is no fall in BP
Bosentan 62.5 mg BD initially for 1 month and then increased to 125 mg BD
All India Institute Of Medical Sciences
New Delhi, National Capital Territory of Delhi, India
RECRUITINGEchocardiogram
Improvement in pulmonary artery pressures
Time frame: 6 months
WHO functional classification
Improvement in WHO functional classification
Time frame: 6 months
6 minute walk test
Improvement in 6 minute walk test
Time frame: 6 months
Pulmonary function test
Improvement in Pulmonary function test
Time frame: 6 months
Visual analog scale for dyspnea
Improvement in Visual analog scale for dyspnea
Time frame: 6 months
Echocardiography measuring pulmonary artery pressure
Improvement in pulmonary artery pressures measured by Echocardiography
Time frame: 3 months
WHO functional classification
Improvement in WHO functional classification
Time frame: 3 months
6 minute walk test
Improvement in 6 minute walk test
Time frame: 3 months
Pulmonary function test
Improvement in Pulmonary function test
Time frame: 3 months
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Visual analog scale for dyspnea
Improvement in Visual analog scale for dyspnea
Time frame: 3 months
Biochemical markers at 3 and 6 months
Levels of biomarkers such as Trop T, pro-BNP, uric acid at 3 months and 6 months after starting the drugs
Time frame: 6 months
Monitoring side effects of the drugs
adverse events and serious adverse events will be closely monitored and reported to the ethics committee and DCGI immediately
Time frame: 6 months