Clinical efficacy of tadalafil compared to sildenafil in treatment of moderate to severe canine pulmonary hypertension: a pilot study.
Clinical efficacy of tadalafil compared to sildenafil in treatment of moderate to severe canine pulmonary hypertension: a pilot study.
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他达拉非与西地那非治疗中度至重度犬肺动脉高压的临床疗效：一项初步研究。
DOI：
10.1016/j.jvc.2019.05.001
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Reinero,CR
中科院分区：
文献类型：
--
作者：
Jaffey,JA;Leach,SB;Kong,LR;Wiggen,KE;Bender,SB;Reinero,CR
犬肺动脉高压（PH）具有较高的发病率和死亡率。他达拉非是一种磷酸二酯酶-5抑制剂，通常用于患有PH的人，但尚未在患有自然PH的狗的临床试验中进行评估。我们的目的是比较他达拉非和西地那非对PH的疗效，通过三尖瓣峰值反流速度、估计收缩期肺动脉压梯度、自主活动、生活质量、动物入选了23只超声心动图显示为中度至重度PH的狗。方法采用前瞻性、短期、随机、双盲先导研究。患有PH的狗被随机分配接受西地那非或他达拉非治疗2周，并通过超声心动图、活动监测仪和主人报告的结果进行评估。结果总体而言，磷酸二酯酶-5抑制显著降低（改善）生活质量评分（p= 0.003）和视觉模拟评分（p= 0.024），这些变量在治疗间无显著差异。磷酸二酯酶-5抑制对三尖瓣峰值反流速度（p= 0.056）和自主活动（p= 0.27）没有显著影响。共有33%（7/21）的狗在研究期间至少经历了一次不良事件（他达拉非，n = 5；西地那非，n = 2），治疗类型和不良事件发生率之间无显著差异（p= 0.36）。在这项初步研究中，磷酸二酯酶-5抑制导致生活质量评分的明显改善，但没有证明他达拉非优于西地那非。结论他达拉非2 mg/kg每日1次可替代西地那非治疗中重度PH。
IntroductionCanine pulmonary hypertension (PH) is associated with high morbidity and mortality. Tadalafil, a phosphodiesterase-5 inhibitor used commonly in humans with PH, has not been evaluated in a clinical trial in dogs with naturally occurring PH. Our objectives were to compare the efficacy of tadalafil and sildenafil on PH assessed by peak tricuspid regurgitant flow velocity, estimated systolic pulmonary arterial pressure gradient, voluntary activity, quality of life, and safety profiles in dogs with moderate to severe PH.AnimalsTwenty-three dogs with echocardiographic evidence of moderate to severe PH were enrolled.MethodsA prospective short-term, randomized, double-blinded pilot study was carried out. Dogs with PH were randomly allocated to receive sildenafil or tadalafil for 2 weeks and assessed via echocardiography, activity monitors, and owner-reported outcomes.ResultsCollectively, phosphodiesterase-5 inhibition significantly decreased (improved) quality of life scores (p= 0.003) and visual analog score (p= 0.024) without significant between-treatment difference of these variables. Phosphodiesterase-5 inhibition did not significantly affect peak tricuspid regurgitant flow velocity (p= 0.056) or voluntary activity (p= 0.27). A total of 33% (7/21) of dogs experienced at least one adverse event during the study (tadalafil, n = 5; sildenafil, n = 2) with no significant difference between treatment type and incidence of adverse events (p= 0.36).DiscussionIn this pilot study, phosphodiesterase-5 inhibition led to apparent improvement in quality of life scores without documenting superiority of tadalafil over sildenafil.ConclusionTadalafil at a dose of 2 mg/kg once daily appears to be a viable alternative to sildenafil in dogs with moderate to severe PH.
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