beraprost and Vascular-Diseases

The clinical usefulness of prostaglandin derivatives was reviewed for the treatment of peripheral vascular diseases such as arteriosclerosis obliterans, Buerger's disease, Raynaud's disease, and collagen disease etc. PGE1 was initially used for this purpose, however, it had to be infused intra-arterially or intravenously for hours. PGE1 incorporated in lipid microsphere (Lipo PGE1) was made for one-shot use and the targeting drug delivery because the lipid microsphere is easily taken up by some inflammatory cells. Lipo PGE1 was revealed to be effective to improvement of considerably large ischemic ulcer and pain. Beraprost sodium (PGI2 derivative) was produced for oral use, and has been widely used. The effectiveness was similar to Lipo PGE1, but the complications such as hypotension, headache, and numbness were more common in PGI2.

Topics: Alprostadil; Epoprostenol; Humans; Vascular Diseases

Earlier studies have shown that administration of beraprost sodium (BPS), an orally active prostacyclin analogue, improves hemodynamics in patients with primary pulmonary hypertension (PH), but it is not known whether BPS has beneficial effects in secondary precapillary PH. The present study investigated the hemodynamic and hormonal parameters of 18 patients with secondary precapillary PH (8 patients with chronic thromboembolic PH, 7 with collagen vascular disease, and 3 with residual PH after surgery for atrial septal defect). Hemodynamics were repeatedly measured by right heart catheterization. Treatment with BPS improved New York Heart Association (NYHA) functional class in 10 of the 18 patients and significantly decreased pulmonary vascular resistance by 17% (12.9+/-1.1 to 10.7+/-1.2 Wood units, p<0.01). Circulating brain natriuretic peptide and uric acid significantly decreased from 246+/-61 to 215+/-65 pg/ml and from 6.5+/-0.6 to 5.3+/-0.3 mg/dl, respectively. In summary, BPS therapy improved NYHA functional class, hemodynamics, and hormonal parameters in patients with secondary precapillary PH. Thus, oral administration of BPS may be a new therapeutic strategy for the treatment of secondary precapillary PH.

Topics: Administration, Oral; Capillaries; Epoprostenol; Female; Hemodynamics; Humans; Hypertension, Pulmonary; Male; Middle Aged; Thromboembolism; Vascular Diseases; Vasodilator Agents