Sildenafil (Viagra) causes preferential pulmonary vasodilation, according to results of an open-label trial published in the Sept. 21 issue of The Lancet. The authors and editorialist therefore suggest that sildenafil may in the future become the drug of choice for secondary pulmonary hypertension related to pulmonary fibrosis.
“Controlled randomized trials should be done to confirm our findings,” lead author Hossein A. Ghofrani, MD, from University Hospital in Giessen, Germany, says in a news release. “However, the unique profile of sildenafil, not previously shown for a systemically administered agent, suggests that the drug is a promising candidate for long-term treatment of secondary pulmonary hypertension in lung fibrosis.”
In this preliminary controlled trial, 16 individuals with pulmonary hypertension secondary to pulmonary fibrosis received nitric oxide inhalation and were then randomized to treatment with oral sildenafil or intravenous epoprostenol. Only those patients who received sildenafil had a reduction in the ratio of pulmonary to systemic vascular resistance. Both nitric oxide and sildenafil maintained ventilation/perfusion matching, and sildenafil raised arterial partial pressure of oxygen (14.3 mm Hg, 95% confidence interval, -1.7 to 31.3). No adverse events were reported.
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