Ambrisentan ± tadalafil in WHO functional class II/III pulmonary arterial hypertension: a guide to its use in the EU

• Published in: Drugs & therapy perspectives : for rational drug selection and use Vol. 34; no. 7; pp. 289 - 299
• Main Authors: Lyseng-Williamson, Katherine A., Behr, Jürgen
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.07.2018; Springer Nature B.V
• Subjects: Adis Drug Q&A; Disease management; Drug dosages; Exercise; Medicine; Nitric oxide; Patients; Pharmacotherapy; Pharmacy; Physical fitness; Pulmonary arteries; Pulmonary hypertension; Smooth muscle; Europe
• ISSN: 1172-0360; 1179-1977
• DOI: 10.1007/s40267-018-0531-1

Ambrisentan [Volibris ® (EU), Letairis ® (USA)], an endothelin-1 receptor antagonist, is effective in treating WHO functional class (FC) II/III pulmonary arterial hypertension (PAH) when used as monotherapy or in combination with tadalafil (a phosphodiesterase type-5 inhibitor). In patients with idiopathic PAH or PAH associated with connective tissue diseases, ambrisentan monotherapy provided sustained clinical benefits, including improvements in exercise capacity. Clinical benefits, including a lower risk of clinical failure, were greater with initial combination treatment with ambrisentan + tadalafil than with initial monotherapy with either ambrisentan or tadalafil in patients with PAH, including those in various patient subgroups. Ambrisentan has an acceptable tolerability and safety profile with or without concomitant tadalafil. Based on the results of clinical trials, current guidelines recommend ambrisentan as initial mono- or combination treatment in patients with non-vasoreactive WHO FC class II/III PAH.