title: Sildenafil to improve respiratory rehabilitation outcomes in COPD: a controlled trial.
abstract: Pulmonary hypertension is a serious complication of chronic obstructive pulmonary disease (COPD) that currently has no established pharmacological treatment. This study aimed to assess whether concomitant treatment with sildenafil would enhance the results of pulmonary rehabilitation in patients with COPD and increased pulmonary arterial pressure (PAP). In this double-blind, randomised controlled trial patients received 20 mg sildenafil or placebo three times daily and underwent pulmonary rehabilitation for 3 months. The primary end-point was the gain in the cycle endurance time at a constant work-rate. Secondary end-points included performance in the incremental exercise test, 6-min walk distance and quality of life. 63 patients with severe COPD and moderately increased PAP were randomised. Cycle endurance time increased by 149 s (95% CI 26-518 s) in the sildenafil group and by 169 s (95% CI 0-768 s) in the placebo group (median change difference -7 s, 95% CI -540-244 s; p=0.77). Gains in the incremental exercise test, 6-min walk distance and quality of life at the end of the study did not differ between groups. Measurements of arterial oxygenation and adverse events were similar in both groups. In patients with severe COPD and moderately increased PAP, concomitant treatment with sildenafil does not improve the results of pulmonary rehabilitation in exercise tolerance.
authors: Hospital Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona.
authors: Isabel
authors: I
authors: Blanco
authors: Salud
authors: S
authors: Santos
authors: Joaqím
authors: J
authors: Gea
authors: Rosa
authors: R
authors: Güell
authors: Ferran
authors: F
authors: Torres
authors: Elena
authors: E
authors: Gimeno-Santos
authors: Diego A
authors: DA
authors: Rodriguez
authors: Jordi
authors: J
authors: Vilaró
authors: Begona
authors: B
authors: Gómez
authors: Josep
authors: J
authors: Roca
authors: Joan Albert
authors: JA
authors: Barberà
mesh_terms: D000368:Aged; D062186:Arterial Pressure; D004311:Double-Blind Method; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D010919:Placebos; D011651:Pulmonary Artery / Q000473:pathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy*; D011687:Purines / Q000627:therapeutic use; D011788:Quality of Life; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D010879:Piperazines; D010919:Placebos; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate