title: Acute effects of aerosolized iloprost in COPD related pulmonary hypertension - a randomized controlled crossover trial.
abstract: BACKGROUND
  Inhaled iloprost potentially improves hemodynamics and gas exchange in patients with chronic obstructive pulmonary disease (COPD) and secondary pulmonary hypertension (PH).
  
  
  OBJECTIVE
  To evaluate acute effects of aerosolized iloprost in patients with COPD-associated PH.
  
  
  METHODS
  A randomized, double blind, crossover study was conducted in 16 COPD patients with invasively confirmed PH in a single tertiary care center. Each patient received a single dose of 10 µg iloprost (low dose), 20 µg iloprost (high dose) and placebo during distinct study-visits. The primary end-point of the study was exercise capacity as assessed by the six minute walking distance.
  
  
  RESULTS
  Both iloprost doses failed to improve six-minute walking distance (p = 0.36). Low dose iloprost (estimated difference of the means -1.0%, p = 0.035) as well as high dose iloprost (-2.2%, p<0.001) significantly impaired oxygenation at rest. Peak oxygen consumption and carbon dioxide production differed significantly over the three study days (p = 0.002 and p = 0.003, accordingly). As compared to placebo, low dose iloprost was associated with reduced peak oxygen consumption (-76 ml/min, p = 0.002), elevated partial pressure of carbon dioxide (0.27 kPa, p = 0.040) and impaired ventilation during exercise (-3.0l/min, p<0.001).
  
  
  CONCLUSIONS
  Improvement of the exercise capacity after iloprost inhalation in patients with COPD-associated mild to moderate PH is very unlikely.
  
  
  BACKGROUND
  Controlled-Trials.com ISRCTN61661881.
authors.affiliation: Clinic of Pulmonary Medicine and Respiratory Cell Research, University Hospital Basel, Basel, Switzerland.
authors.forename: Lucas
authors.initials: L
authors.lastname: Boeck
authors.forename: Michael
authors.initials: M
authors.lastname: Tamm
authors.forename: Peter
authors.initials: P
authors.lastname: Grendelmeier
authors.forename: Daiana
authors.initials: D
authors.lastname: Stolz
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000336:Aerosols; D000368:Aged; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D016285:Iloprost / Q000008:administration & dosage* / Q000378:metabolism / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D010100:Oxygen / Q000378:metabolism; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D011659:Pulmonary Gas Exchange / Q000187:drug effects
chemical_list: D000336:Aerosols; D016285:Iloprost; D010100:Oxygen