Sildenafil for chronic obstructive pulmonary disease: a randomized crossover trial.

Area of Science:

• Pulmonary Medicine
• Pharmacology

Background:

• Exercise limitation is common in chronic obstructive pulmonary disease (COPD) with emphysema.
• Pulmonary hypertension during exercise may contribute to COPD exercise limitation.

Purpose of the Study:

• To determine the effects of sildenafil on exercise capacity in patients with COPD and emphysema without pulmonary hypertension.

Main Methods:

• A randomized, double-blind, placebo-controlled, 2-period crossover trial was conducted.
• Ten adults with COPD and emphysema received sildenafil or placebo for 4 weeks, followed by a 1-week washout, then the alternative treatment.
• Primary outcomes included 6-minute walk distance and peak exercise oxygen consumption.

Main Results:

• Sildenafil did not significantly improve 6-minute walk distance or peak exercise oxygen consumption.
• Sildenafil increased the alveolar-arterial oxygen gradient and worsened symptoms and quality of life.
• Adverse events were more frequent with sildenafil treatment.

Conclusions:

• Sildenafil administration did not benefit exercise capacity in COPD patients without pulmonary hypertension.
• Sildenafil negatively impacted gas exchange and quality of life in this patient group.