Source: Annual Congress 2003 - Pulmonary hypertension

Abstract

Epoprostenol is used for the treatment of pulmonary arterial hypertension (PAH). However, it has serious side-effects and the use of a permanent catheter with frequent medication changes conditionates patient autonomy. To what extent the benefits of epoprostenol predominate over its disadvantages on perceived quality of life (QOL) remains undetermined. We evaluated the impact of i.v. epoprostenol on heath-related QOL by using 2 questionnaires: a generic (short form 36 item survey,SF36) and a specific for respiratory disorders (St.George‘s, SGRQ). 11 patients with PAH (6F/5M; 37±5 yrs) with severe PAH treated with epoprostenol for 21 months (range, 6-43) were included. Patients were evaluated at baseline, 6,12 and 24 months of treatment. Results are shown in the table.
Before treatment, perceived QOL was poor, as assessed by both questionnaires. 3 patients died during the follow-up. Adverse effects were common, but only in one case treatment had to be discontinued because of catheter-related sepsis. Patients treated with i.v. epoprostenol for more than 12 months perceived significant improvement in QOL. Major changes were noticed when using the specific respiratory questionnaire (SGRQ) (symptoms, activity and impact domains). We conclude that long-term treatment with i.v. epoprostenol provides improvement in QOL despite the disadvantages inherent to delivery system.

	Baseline	6 mo	12 mo	24 mo
SF36-Physical	33±3	36±4	46±2*	46±3
SF36-Mental	45±4	42±3	46±2	52±4*
SGRQ-Total	55±4	47±5	34±4*	34±6*

(*p<0.05 compared with baseline)

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Citations should be made in the following way:
C. Hernandez, S. Santos, J. Roca, E. Sala, F. Burgos, R. Rodriguez-Roisin, J. A. Barbera (Barcelona, Palma de Mallorca, Spain). Effect of intravenous epoprostenol on quality of life in pulmonary arterial hypertension. Eur Respir J 2003; 22: Suppl. 45, 3536

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