title: Down patients with Eisenmenger syndrome: is bosentan treatment an option?
abstract: BACKGROUND
  Favorable results of treatment with bosentan in patients with Eisenmenger syndrome are available. However, data in Down patients are lacking. In this study, we evaluate the therapeutic role of bosentan treatment in Down patients with Eisenmenger syndrome.
  
  
  METHODS
  In this open-label study, 24 Down patients (>18 years) with Eisenmenger syndrome (17 males) were treated with bosentan. Their mean age was 38 years (range 19-55 years). All Down patients were evaluated at baseline and during follow-up with laboratory tests, six-minute walk test (6-MWT), Doppler echocardiography, and quality of life questionnaires.
  
  
  RESULTS
  The median follow-up of Down patients treated with bosentan was 11.5 months (range 3-23 months). Induction of oral bosentan therapy was well tolerated among all 24 Down patients. Bosentan treatment was generally well tolerated. No serious adverse drug reactions were noted. Median 6-MWT increased from 296 m (range 40-424 m) to 325 m (range 84-459 m, p<0.05) after 12 weeks. After 26 and 52 weeks of treatment with bosentan, median 6-MWT distance was 276 m (range 140-462 m, n=15, p=0.6) and 287 m (range 131-409 m, n=7, p=0.3), respectively. Quality of life questionnaire scores remained stable during treatment.
  
  
  CONCLUSIONS
  Also patients with Down syndrome may benefit from bosentan treatment when they have Eisenmenger syndrome. Medical treatment appears to be safe and the treatment effects do not deviate from those observed in Eisenmenger patients without Down syndrome.
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Mariëlle G J
authors.initials: MG
authors.lastname: Duffels
authors.forename: Jeroen C
authors.initials: JC
authors.lastname: Vis
authors.forename: Rosa L E
authors.initials: RL
authors.lastname: van Loon
authors.forename: Rolf M F
authors.initials: RM
authors.lastname: Berger
authors.forename: Elke S
authors.initials: ES
authors.lastname: Hoendermis
authors.forename: Arie P J
authors.initials: AP
authors.lastname: van Dijk
authors.forename: Berto J
authors.initials: BJ
authors.lastname: Bouma
authors.forename: Barbara J M
authors.initials: BJ
authors.lastname: Mulder
mesh_terms: D000328:Adult; D000077300:Bosentan; D004314:Down Syndrome / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D004541:Eisenmenger Complex / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013449:Sulfonamides / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013449:Sulfonamides; D000077300:Bosentan