title: Safety experience with bosentan in 146 children 2-11 years old with pulmonary arterial hypertension: results from the European Postmarketing Surveillance program.
abstract: The oral dual endothelin receptor antagonist bosentan has been shown to improve the short- and medium-term course of adult pulmonary arterial hypertension (PAH); however, data from clinical studies in children are limited. This analysis investigated the safety profile of bosentan in pediatric patients in a European, prospective, noninterventional, Internet-based postmarketing surveillance database (Tracleer PMS). Pediatric patients (aged 2-11 y) were compared with patients aged > or =12 y. Over a 30-mo period, 4994 patients, including 146 bosentan-naïve pediatric patients (51.4% males), were captured in the database. Predominant etiologies in children were idiopathic PAH (40.4%) and PAH related to congenital heart disease (45.2%). The majority of children were in New York Heart Association functional class II (28.1%) or III (50.7%), and median exposure to bosentan was 29.1 wk. Elevated aminotransferases were reported in 2.7% of children versus 7.8% of patients > or =12 y. The discontinuation rate was 14.4% in children versus 28.1% in patients > or =12 y. The Tracleer PMS results provide unique information on pediatric PAH in Europe. They also suggest that Tracleer may be better tolerated in children than in adults. This observation confirms the value of monthly monitoring of liver function for the duration of bosentan treatment.
authors.affiliation: Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland. Maurice.Beghetti@hcuge.ch
authors.forename: Maurice
authors.initials: M
authors.lastname: Beghetti
authors.forename: Marius M
authors.initials: MM
authors.lastname: Hoeper
authors.forename: David G
authors.initials: DG
authors.lastname: Kiely
authors.forename: Joern
authors.initials: J
authors.lastname: Carlsen
authors.forename: Barbara
authors.initials: B
authors.lastname: Schwierin
authors.forename: Eleanor S
authors.initials: ES
authors.lastname: Segal
authors.forename: Marc
authors.initials: M
authors.lastname: Humbert
mesh_terms: D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D000077300:Bosentan; D002648:Child; D002675:Child, Preschool; D005060:Europe; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000378:metabolism; D008099:Liver / Q000201:enzymology; D008137:Longitudinal Studies; D008297:Male; D011358:Product Surveillance, Postmarketing; D013449:Sulfonamides / Q000009:adverse effects* / Q000627:therapeutic use*; D000637:Transaminases / Q000378:metabolism
chemical_list: D000959:Antihypertensive Agents; D013449:Sulfonamides; D000637:Transaminases; D000077300:Bosentan