Sildenafil for treatment of advanced idiopathic pulmonary fibrosis?

January 01, 0001

Sildenafil for treatment of advanced idiopathic pulmonary fibrosis?

These US authors tested the hypothesis that treatment with sildenafil would improve walk distance, dyspnea, and quality of life in patients with advanced idiopathic pulmonary fibrosis, defined as a carbon monoxide diffusion capacity of less than 35% of the predicted value. They conducted a double-blind, randomized, placebo-controlled trial of sildenafil in two periods. The first period consisted of 12 weeks of a double-blind comparison between sildenafil and a placebo control. The second period was a 12-week open-label evaluation involving all patients receiving sildenafil.

They found: "A total of 180 patients were enrolled in the study. The difference in the primary outcome was not significant, with 9 of 89 patients (10%) in the sildenafil group and 6 of 91 (7%) in the placebo group having an improvement of 20% or more in the 6-minute walk distance. There were small but significant differences in arterial oxygenation, carbon monoxide diffusion capacity, degree of dyspnea, and quality of life favoring the sildenafil group. Serious adverse events were similar in the two study groups."

This study did not show a benefit for sildenafil for the primary outcome. The presence of some positive secondary outcomes creates clinical equipoise for further research.

Benefit seems doubtful.

For the full abstract, click here.

N Engl J Med 363:620-628, 12 August 2010
© 2010 to the Massachusetts Medical Society
A Controlled Trial of Sildenafil in Advanced Idiopathic Pulmonary Fibrosis. The Idiopathic Pulmonary Fibrosis Clinical Research Network. Correspondence to Dr. Zisman: [email protected]

Category: R. Respiratory. Keywords: idiopathic pulmonary fibrosis, sildenafil, walk distance, dyspnea, quality of life, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 31 August 2010

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