Appetite suppressants and primary pulmonary hypertension in the United Kingdom.
OBJECTIVE
Amphetamine-like appetite suppressants, particularly fenfluramines, have been implicated in the aetiology of primary pulmonary hypertension. At one specialist centre in France 20% of patients with primary pulmonary hypertension had been exposed to fenfluramine. The prevalence of primary pulmonary hypertension associated with fenfluramines and other appetite suppressants in the United Kingdom is unknown. This study was performed to measure prior exposure to appetite suppressants in patients with primary pulmonary hypertension.


METHODS
Heart lung transplantation centres in England.


METHODS
United Kingdom residents with proven primary pulmonary hypertension referred for consideration of heart lung transplantation.


METHODS
Case surveillance study, obtaining data from the hospital and general practitioner's notes and directly from the patients or their relatives.


RESULTS
55 patients were identified. Drug histories were available from hospital records in all patients, from the general practitioner's notes in 51, and from the patients or relatives in 44. Of these, 3 female patients had been exposed to appetite suppressants (2 fenfluramine, 1 diethylpropion): 2 have since died. In each case exposure was brief and apparently predated the development of symptoms by several years.


CONCLUSIONS
Exposure of patients with severe primary pulmonary hypertension to fenfluramine and other appetite suppressants is uncommon in the United Kingdom unlike in France, where most of the cases associating primary pulmonary hypertension with fenfluramine use have originated. This may reflect more conservative prescribing of these agents in the United Kingdom.
Wolfson Unit of Clinical Pharmacology, University of Newcastle upon Tyne, Newcastle.
S H
SH
Thomas
A Y
AY
Butt
P A
PA
Corris
J J
JJ
Egan
T W
TW
Higenbottam
B P
BP
Madden
P C
PC
Waller
D000328:Adult; D001067:Appetite Depressants / Q000009:adverse effects*; D004053:Diethylpropion / Q000009:adverse effects; D005260:Female; D005277:Fenfluramine / Q000009:adverse effects; D016041:Heart-Lung Transplantation; D006801:Humans; D006976:Hypertension, Pulmonary / Q000139:chemically induced*; D008297:Male; D012189:Retrospective Studies; D006113:United Kingdom
D001067:Appetite Depressants; D005277:Fenfluramine; D004053:Diethylpropion