title: Safety and efficacy evaluation of  ambrisentan  in pulmonary hypertension.
abstract: BACKGROUND
  Pulmonary arterial hypertension (PAH) is characterized by an increase in pulmonary vascular resistance, which can lead to right heart failure and death. Endothelin-1 binding ETA and ETB receptors seem to play a critical role in the pathogenesis and progression of the disease, and oral endothelin receptor antagonists (ERAs) have been shown to be an effective treatment. Bosentan and ETA-selective ambrisentan are the ERAs currently available for PAH treatment.
  
  
  METHODS
  On the basis of the analysis of the literature, this paper addresses the efficacy and safety of ambrisentan in the treatment for PAH.
  
  
  CONCLUSIONS
  Ambrisentan has shown an efficacy comparable with other ERAs. Compared with bosentan, ambrisentan seems to have a better safety profile with regards to hepatic safety and drug-drug interactions. On the other hand, ambrisentan shows a higher rate of other adverse events, such as nasal congestion and peripheral edema. Ambrisentan is a viable option for PAH treatment. However, there is still a need for more robust data about long-term mortality, treatment in non-PAH pulmonary hypertension (PH) (such as PH due to left heart disease and PH due to chronic hypoxic lung diseases) and combination therapy.
authors.affiliation: Sapienza University of Rome, Department of Cardiovascular and Respiratory Disease, Rome, Italy.
authors.forename: Carmine Dario
authors.initials: CD
authors.lastname: Vizza
authors.forename: Francesco
authors.initials: F
authors.lastname: Fedele
authors.forename: Beatrice
authors.initials: B
authors.lastname: Pezzuto
authors.forename: Lewis J
authors.initials: LJ
authors.lastname: Rubin
mesh_terms: D000818:Animals; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000077300:Bosentan; D018450:Disease Progression; D004347:Drug Interactions; D065130:Endothelin A Receptor Antagonists; D065627:Familial Primary Pulmonary Hypertension; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000503:physiopathology; D010666:Phenylpropionates / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D011724:Pyridazines / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D044023:Receptor, Endothelin B / Q000378:metabolism; D013449:Sulfonamides / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D065130:Endothelin A Receptor Antagonists; D010666:Phenylpropionates; D011724:Pyridazines; D044023:Receptor, Endothelin B; D013449:Sulfonamides; C467894:ambrisentan; D000077300:Bosentan