Initial experience with tadalafil in pediatric pulmonary arterial hypertension

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Shinichi Takatsuki1, Michelle Calderbank, David Dunbar Ivy

  • 1Division of Pediatric Cardiology, Department of Pediatrics, Children's Hospital Colorado University of Colorado School of Medicine, 13123 East 16th Avenue, B100, Aurora, CO 80045, USA. tekeshin0621@msn.com

Pediatric Cardiology
|March 10, 2012
PubMed

Insights

Tadalafil is safe and effective for pediatric patients with pulmonary arterial hypertension (PAH). Switching from sildenafil to tadalafil improved hemodynamics and may prevent disease progression in children with PAH.

Area of Science:

  • Pediatric Cardiology
  • Pharmacology
  • Pulmonology

Background:

  • Pulmonary arterial hypertension (PAH) requires effective treatment in pediatric patients.
  • Sildenafil is a common treatment, but once-daily dosing of tadalafil offers a potential advantage.

Purpose of the Study:

  • To evaluate the safety, tolerability, and efficacy of tadalafil in pediatric PAH patients.
  • To compare tadalafil's effects after switching from sildenafil versus initial tadalafil therapy.

Main Methods:

  • Retrospective analysis of 33 pediatric PAH patients.
  • 29 patients transitioned from sildenafil to tadalafil; 4 received tadalafil initially.
  • Hemodynamic parameters assessed via repeat catheterization in a subset of patients.

Main Results:

  • Transition to tadalafil showed significant improvements in mean pulmonary arterial pressure and pulmonary vascular resistance index (p < 0.05).
  • Clinical improvement was observed in patients receiving initial tadalafil therapy.
  • Adverse events were similar between sildenafil and tadalafil groups; tadalafil was generally well-tolerated.

Conclusions:

  • Tadalafil is a safe and effective treatment option for pediatric PAH.
  • Switching to tadalafil from sildenafil can lead to hemodynamic improvements.
  • Tadalafil may help prevent disease progression in children with PAH.

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