Pulmonary hypertension associated with benfluorex exposure

Area of Science:

• Cardiology
• Pulmonology
• Pharmacology

Background:

• Benfluorex, marketed until 2009, shares pharmacological properties with fenfluramine derivatives, known causes of pulmonary arterial hypertension (PAH).
• Previous associations between fenfluramines and PAH necessitate investigation into benfluorex's potential role in causing pulmonary hypertension (PH).

Purpose of the Study:

• To report the clinical and hemodynamic characteristics of patients with PH associated with benfluorex exposure.
• To identify risk factors and co-existing conditions in benfluorex-induced PH.

Main Methods:

• Analysis of 85 cases of PH associated with benfluorex exposure identified by the French PAH Network (June 1999 - March 2011).
• Confirmation of pre-capillary PH in 70 patients.
• Review of exposure duration, latency period, and co-exposure to other drugs.

Main Results:

• 70 out of 85 patients had confirmed pre-capillary PH.
• Median benfluorex exposure was 30 months, with a median latency of 108 months to diagnosis.
• 33% had prior fenfluramine/dexfenfluramine exposure; 30% had additional PH risk factors.
• 25% showed coexisting PH and cardiac valve involvement.

Conclusions:

• Benfluorex exposure is strongly suggested as a potent trigger for PAH.
• Clinical and hemodynamic data support a causal link between benfluorex and PAH development.
• Awareness of benfluorex's cardiotoxic potential is crucial for managing PH patients.