title: Dehydroepiandrosterone (DHEA) improves pulmonary hypertension in chronic obstructive pulmonary disease (COPD): a pilot study.
abstract: OBJECTIVE
  It was previously shown that dehydroepiandrosterone (DHEA) reverses chronic hypoxia-induced pulmonary hypertension (PH) in rats, but whether DHEA can improve the clinical and hemodynamic status of patients with PH associated to chronic obstructive pulmonary disease (PH-COPD) has not been studied whereas it is a very severe poorly treated disease.
  
  
  METHODS
  Eight patients with PH-COPD were treated with DHEA (200mg daily orally) for 3 months. The primary end-point was the change in the 6-minute walk test (6-MWT) distance. Secondary end-points included pulmonary hemodynamics, lung function tests and tolerance of treatment.
  
  
  RESULTS
  The 6-MWT increased in all cases, from 333m (median [IQR]) (257; 378) to 390m (362; 440) (P<0.05). Mean pulmonary artery pressure decreased from 26mmHg (25; 27) to 21.5mmHg (20; 25) (P<0.05) and pulmonary vascular resistance from 4.2UI (3.5; 4.4) to 2.6UI (2.5; 3.8) (P<0.05). The carbon monoxide diffusing capacity of the lung (DLCO % predicted) increased significantly from 27.4% (20.1; 29.3) to 36.4% (14.6; 39.6) (P<0.05). DHEA treatment did not change respiratory parameters of gas exchange and the 200mg per day of DHEA used was perfectly tolerated with no side effect reported.
  
  
  CONCLUSIONS
  DHEA treatment significantly improves 6-MWT distance, pulmonary hemodynamics and DLCO of patients with PH-COPD, without worsening gas exchange, as do other pharmacological treatments of PH (trial registration NCT00581087).
authors.affiliation: université Bordeaux, CHU de Bordeaux, Bordeaux, France. edumasdlr@gmail.com
authors.forename: Eric
authors.initials: E
authors.lastname: Dumas de La Roque
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Savineau
authors.forename: Anne-Cécile
authors.initials: AC
authors.lastname: Metivier
authors.forename: Marc-Alain
authors.initials: MA
authors.lastname: Billes
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Kraemer
authors.forename: Stéphane
authors.initials: S
authors.lastname: Doutreleau
authors.forename: Jacques
authors.initials: J
authors.lastname: Jougon
authors.forename: Roger
authors.initials: R
authors.lastname: Marthan
authors.forename: Nicholas
authors.initials: N
authors.lastname: Moore
authors.forename: Michael
authors.initials: M
authors.lastname: Fayon
authors.forename: Etienne-Émile
authors.initials: EÉ
authors.lastname: Baulieu
authors.forename: Claire
authors.initials: C
authors.lastname: Dromer
mesh_terms: D000328:Adult; D003687:Dehydroepiandrosterone / Q000627:therapeutic use*; D005080:Exercise Test; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D012129:Respiratory Function Tests; D014655:Vascular Resistance / Q000187:drug effects; D016138:Walking
chemical_list: D003687:Dehydroepiandrosterone