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Sildenafil in pediatric pulmonary arterial hypertension

A K Dhariwal1, S B Bavdekar

  • 1Department of Pediatrics, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India.

Journal of Postgraduate Medicine
|June 30, 2015
PubMed

Insights

Pulmonary arterial hypertension (PAH) treatment in children faces challenges due to a USFDA warning on sildenafil. This review examines sildenafil

Area of Science:

  • Pediatric Cardiology
  • Pulmonology
  • Pharmacology

Background:

  • Pulmonary arterial hypertension (PAH) is a severe condition with limited curative options.
  • Advances in understanding PAH pathophysiology and diagnosis have improved patient outlook.
  • Sildenafil is a widely used off-label drug for pediatric PAH management.

Purpose of the Study:

  • To review the use of sildenafil in treating pediatric pulmonary arterial hypertension.
  • To address the implications of the 2012 USFDA warning on sildenafil use in children with PAH.

Main Methods:

  • Literature review of studies on sildenafil for pediatric PAH.
  • Analysis of regulatory guidance and clinical practice trends.
  • Examination of the efficacy and safety data of sildenafil in children.

Main Results:

  • Sildenafil has been extensively used off-label for pediatric PAH.
  • A 2012 USFDA warning discouraged high-dose sildenafil use in children with PAH.
  • This has created a therapeutic gap, with limited approved treatments.

Conclusions:

  • The use of sildenafil in pediatric PAH requires careful consideration due to regulatory concerns.
  • Further research and approved therapies are needed for effective pediatric PAH management.
  • This review highlights the complexities of managing pediatric PAH with available, albeit restricted, therapeutic options.

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