Oral beraprost, in combination with standard therapy, may help decrease pulmonary arterial pressure, and improve heart function and exercise capacity in patients with pulmonary hypertension (PH), a study says.
The findings of the study, “Effect of beraprost on pulmonary hypertension due to left ventricular systolic dysfunction,” were published in the journal Medicine.
PH is a rare, life-threatening disorder caused by a narrowing of the arteries in the lungs, often coupled with heart dysfunction, leading to high pulmonary arterial pressure (PAP).
Beraprost, a therapy available under several brand names, is an oral analog of prostacyclin — a molecule naturally produced in the body that dilates blood vessels (vasodilator) — that has strong anti-coagulant and vasodilatory properties.
It’s mostly used to treat intermittent claudication (muscle pain caused by a shortage of blood supply to a region), pain, and peripheral chronic arterial occlusive disease (a circulatory disease in which narrowed arteries restrict blood circulation to the limbs).
Although previous studies demonstrated that taking beraprost might lead to clinically meaningful improvements in patients with primary PH, no studies have addressed its effect on patients whose PH was linked to heart dysfunction.
Therefore, a team of researchers from the Second Affiliated Hospital of Soochow University in China set out to examine the effects of beraprost therapy in a group of patients with PH caused by heart dysfunction.
The prospective study involved a total of 25 Asian patients (average age of 68.9 years), who had been hospitalized at the hospital between January and December 2016 due to heart failure, and who had a confirmed diagnosis of PH by echocardiography and right heart catheterization.
All patients were treated with oral beraprost sodium at a dose of 1 μg/kg/d, three times a day, in addition to their usual medication, which included angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta blockers, and spironolactone. All participants were monitored for a period of one year.
On average, PAP values dropped from 49.5 mm Hg at baseline to 27.0 mm Hg after one year of treatment with beraprost.
In addition, patients’ heart function, measured by the total amount of blood the heart is able to pump to the rest of the body, significantly increased from 34.7% at the beginning of the study to 48.2% after one year of treatment.
Moreover, results from the six-minute walking test (6MWT, a test to assess patients’ exercise capacity) showed the distance patients were able to cover within six minutes significantly increased after one year of treatment (395.7 meters versus 190.1 meters at baseline).
No deaths caused by heart complications, severe bleeding, or liver failure were reported over the course of the study.
“Routine oral administration of beraprost sodium added to the usual treatment may further decrease PAP, and improve [heart function] and [exercise capacity] in patients with [PH associated with heart dysfunction]. Meanwhile, treatment with beraprost exhibited good safety,” the researchers wrote.
“A multicenter randomized controlled clinical trial (ChiCTR-IPR-17012961) with larger samples designed based on the results of this pilot study is [now] in progress,” the team added. “In the near future, we will have more evidence for clinicians.”