title: Inhaled low-dose iloprost for pulmonary hypertension: a prospective, multicenter, open-label study.
abstract: BACKGROUND
  Inhaled iloprost (average >30 µg/d) has been considered an effective treatment for severe pulmonary hypertension (PH). Further evidence also showed that low-dose iloprost given intravenously was equally effective as high-dose iloprost in the therapy of systemic sclerosis.
  
  
  OBJECTIVE
  Patients with pulmonary hypertension will benefit from inhalation of low-dose iloprost.
  
  
  METHODS
  Sixty-two patients with PH were enrolled and initiated with neubulizedlow-dose iloprost (2.5 µg per inhalation, 6× daily) for 24 weeks in 13 medical centers in China. Efficacy endpoints included changes in 6-minute walk distance (6MWD), World Health Organization functional class (WHO-FC), and hemodynamic parameters.
  
  
  RESULTS
  Fourteen patients (22.6%) prematurely discontinued the study: 8 due to clinical worsening (6 in WHO-FCIII-IV at baseline), 4 because of protocol change, and 2 patients lost during follow-up. In the remaining 48 patients, 6MWD was increased from 356 ± 98 meters to 414 ± 99 meters (P < 0.001) and WHO-FC improved significantly (P = 0.006) after 24-week inhalation therapy. Cardiac output, cardiac index, and mixed venous oxygen saturation improved significantly compared with baseline (n = 34, P < 0.05). Most of the hemodynamic parameters improved significantly in patients in WHO-FC II (P < 0.05) but not in patients in WHO-FCIII-IV.
  
  
  CONCLUSIONS
  Low-dose iloprost inhalation significantly improved exercise capacity and functional status in patients with PH. It was well tolerated. The improvement of hemodynamics was confirmed in patients with WHO-FCI-II but not in patients with WHO-FCIII-IV, suggesting the importance of early treatment in patients with advanced disease stages.
authors.affiliation: Center for Diagnosis and Management of Pulmonary Vascular Diseases, Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Yun-Juan
authors.initials: YJ
authors.lastname: Sun
authors.forename: Chang-Ming
authors.initials: CM
authors.lastname: Xiong
authors.forename: Guang-Liang
authors.initials: GL
authors.lastname: Shan
authors.forename: Qing
authors.initials: Q
authors.lastname: Gu
authors.forename: Wei-Jie
authors.initials: WJ
authors.lastname: Zeng
authors.forename: Xian-Ling
authors.initials: XL
authors.lastname: Lu
authors.forename: Feng
authors.initials: F
authors.lastname: Zhu
authors.forename: Zhi-Hong
authors.initials: ZH
authors.lastname: Liu
authors.forename: Xin-Hai
authors.initials: XH
authors.lastname: Ni
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: He
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D002681:China; D017079:Exercise Tolerance / Q000187:drug effects; D005260:Female; D006305:Health Status Indicators; D006339:Heart Rate; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000473:pathology; D016285:Iloprost / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011446:Prospective Studies; D013223:Statistics as Topic; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D016285:Iloprost