Identical twins with primary pulmonary hypertension: beraprost vs epoprostenol.
BACKGROUND
The course of 12-year-old, homozygotic twins with primary pulmonary hypertension (PPH) treated with different vasoactive agents, beraprost vs epoprostenol, is described.


METHODS
Clinical, exercise, and hemodynamic assessments were made at baseline, and at 9 months and 24 months of treatment.


RESULTS
Twin A had a rapid improvement with epoprostenol. In contrast, twin B, initially treated with beraprost, had progressive worsening with subsequent improvement on epoprostenol.


CONCLUSIONS
Epoprostenol was efficacious for identical twins with PPH. A 9-month delay in initiating epoprostenol for twin B did not appear to have irreversible short-term detrimental effects.
Children's Hospital of New York, Columbia University, College of Physicians and Surgeons, New York, NY, USA. esb14@columbia.edu
Erika
E
Berman Rosenzweig
Kelly A
KA
Schmitt
Robert
R
Garofano
Robyn J
RJ
Barst
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002648:Child; D004200:Diseases in Twins; D011464:Epoprostenol / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy / Q000235:genetics*; D014430:Twins, Monozygotic; D014665:Vasodilator Agents / Q000627:therapeutic use*
D000959:Antihypertensive Agents; D014665:Vasodilator Agents; C048081:beraprost; D011464:Epoprostenol