Medical University Vienna, Department of Cardiology, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Expert Opin Pharmacother. 2012 Apr;13(5):747-55. doi: 10.1517/14656566.2012.662220. Epub 2012 Feb 23.
Pulmonary arterial hypertension (PAH) is a progressive occlusive disease affecting the pulmonary vasculature; it carries a poor prognosis. Because right ventricular failure is the key feature of deterioration in PAH patients, vasodilator treatments relieving right ventricular afterload have gained ground in the treatment of this disorder. Phosphodiesterase-5 inhibitors are effective and well tolerated vasodilators that were originally developed for erectile dysfunction. Tadalafil , the first once-daily drug of this class, was approved by the USFDA in May 2009 for the treatment of patients suffering from PAH.
This review outlines the currently available data about tadalafil and its effects in patients with PAH. It also presents evidence from recent clinical trials of tadalafil and discusses potential improvements over existing therapy options and their impact on current treatment strategies.
Tadalafil is an efficacious drug with a favorable side-effect profile and convenient mode of administration. More studies are needed to analyze its impact on survival and to substantiate its role in an upfront combination treatment strategy.
肺动脉高压（PAH）是一种影响肺血管的进行性闭塞性疾病；预后不良。由于右心室衰竭是 PAH 患者病情恶化的关键特征，因此减轻右心室后负荷的血管扩张剂治疗在这种疾病的治疗中得到了广泛应用。磷酸二酯酶-5 抑制剂是最初为治疗勃起功能障碍而开发的有效且耐受性良好的血管扩张剂。他达拉非是该类药物中的第一种每日一次的药物，于 2009 年 5 月获得美国食品和药物管理局（FDA）批准，用于治疗患有 PAH 的患者。
本综述概述了目前关于他达拉非及其在 PAH 患者中的作用的可用数据。它还介绍了来自他达拉非最近临床试验的证据，并讨论了与现有治疗方案相比的潜在改进及其对当前治疗策略的影响。
他达拉非是一种有效药物，具有良好的副作用谱和方便的给药方式。需要更多的研究来分析它对生存的影响，并证实它在一线联合治疗策略中的作用。
