Univ Paris-Sud, Faculte de Medecine and AP-HP Centre de Reference del’Hypertension Pulmonaire Severe, Service de Pneumologie et SoinsIntensifs, Hopital Bicetre, Le Kremlin Bicetre, France
Eur Respir J. 2012 Nov;40(5):1164-72. doi: 10.1183/09031936.00188611. Epub 2012 Apr 20.
Benfluorex was marketed in France until 2009, despite its similar pharmacological properties with fenfluramine and its derivatives known to be a cause of pulmonary arterial hypertension (PAH). The aim of this study is to report clinical and haemodynamic characteristics for patients suffering from pulmonary hypertension (PH) associated with benfluorex exposure that had been identified by the French PAH Network. 85 cases of PH associated with benfluorex exposure were identified by the French PAH Network from June 1999 to March 2011. Of these, 70 patients had confirmed pre-capillary PH. The median duration of exposure was 30 months, with a median of 108 months between start of exposure and diagnosis of the pulmonary vascular disease. 33% of all patients also had prior exposure to fenfluramine or dexfenfluramine, and an additional risk factor for PH was identified in 20 (30%) out of 70 patients with pre-capillary PH. A quarter of patients in this current series showed coexisting PH and mild-to-moderate cardiac valve involvement. The results of our study, together with the accumulated data regarding the known toxic effects of fenfluramine and dexfenfluramine, strongly suggest that benfluorex exposure is a potent trigger for PAH.
苯氟雷司于 2009 年在法国上市，尽管它与芬氟拉明及其衍生物具有相似的药理学特性，而后者已知是肺动脉高压 (PAH) 的病因。本研究的目的是报告由法国 PAH 网络确定的与苯氟雷司暴露相关的肺动脉高压 (PH) 患者的临床和血液动力学特征。1999 年 6 月至 2011 年 3 月，法国 PAH 网络共发现 85 例与苯氟雷司暴露相关的 PH 病例。其中 70 例患者有明确的毛细血管前 PH。暴露的中位持续时间为 30 个月，从暴露开始到诊断肺血管疾病的中位时间为 108 个月。所有患者中有 33% 也有芬氟拉明或右旋芬氟拉明的既往暴露史，70 例毛细血管前 PH 患者中有 20 例（30%）确定了肺动脉高压的其他危险因素。当前研究系列中有四分之一的患者存在共存的 PH 和轻度至中度心脏瓣膜受累。我们的研究结果，以及关于芬氟拉明和右旋芬氟拉明已知毒性作用的累积数据，强烈表明苯氟雷司暴露是 PAH 的一个有力触发因素。
