Lung fibrosis (scarring of the lungs due to inflammation of the alveoli) can be complicated by pulmonary hypertension. Hossein Ardeschir Ghofrani and colleagues from University Hospital, Giessen, Germany, did a preliminary randomised controlled trial to compare the acute effects of oral sildenafil (Viagra) or intravenous epoprostenol (conventional treatment) after the inhalation of nitric oxide in 16 individuals with pulmonary hypertension secondary to lung fibrosis.
A reduction in the ratio of pulmonary to systemic blood resistance--an indication of reduced pulmonary hypertension--was only observed in patients who received sildenafil.
Hossein Ghofrani comments: "Controlled randomised trials should be done to confirm our findings. 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 an accompanying Commentary (p 886), Raed A Dweik from the Cleveland Clinic Foundation, USA, states that "the study by Ghofrani and colleagues adds to growing evidence for the use of sildenafil...in patients with primary and secondary pulmonary hypertension", and that sildenafil "is the best available orally administered selective pulmonary vasodilator".
Contact: Dr H A Ghofrani,
Medical Clinic II,
Department of Internal Medicine,
University Hospital,
Giessen, Klinikstrasse 36, 35392 Giessen, Germany;
T) 49-641-99-42351;
F) 49-641-99-42359;
E) ardeschir.ghofrani@innere.med.uni-giessen.de
Dr RA Dweik, Department of Pulmonary & Critical Care Med/A-90,
Cleveland Clinic Foundation,
9500 Euclid Avenue,
Cleveland, OH 44195, USA;
T) 216-445-5763;
F) 216-445-8160;
E) dweikr@ccf.org
The Lancet