da-8159 and Hypertension--Portal

Phosphodiesterase-5-inhibitors may lower portal pressure.. To investigate the effect of the phosphodiesterase-5-inhibitor udenafil on hepatic and systemic haemodynamics in liver cirrhosis.. In an open-label phase-II-study, patients with liver cirrhosis Child A/B and hepatic venous pressure-gradient ≥ 12 mmHg received 12.5mg/day, 25mg/day, 50mg/day, 75 mg/day (n = 5, each), or 100mg/day (n = 10) udenafil p.o. for one week. On days 0 and 6, hepatic venous pressure-gradient was measured prior to and one hour after drug ingestion. Endpoints were reduction of hepatic venous pressure-gradient from day 0 pre to day 6 post intake and reduction in the acute setting. Pharmacokinetics were measured in the two lowest dosage groups.. Combining the 75 and 100mg/day groups hepatic venous pressure-gradient reduction after drug intake was 19.9% (p = 0.0006) on day 0. From day 0 pre-dose to day 6 post-dose hepatic venous pressure-gradient decreased by 15.7% (p = 0.040) and in 5/15 patients by ≥ 20% or to <12 mmHg. In the 100mg/day group, mean arterial pressure decreased from 98.9 mmHg by 6.2 mmHg (p = 0.037) from day 0 pre-dose to day 6 post-dose. Heart rates or electrocardiograms were unchanged. Udenafil was eliminated with t1/2 = 25 h.. Oral application of 75-100mg of the phosphodiesterase-5-inhibitor udenafil lowers portal pressure in the acute setting by about 20% without relevant systemic cardiovascular side effects.

Topics: Adult; Aged; Blood Pressure; Female; Humans; Hypertension, Portal; Liver Cirrhosis; Male; Middle Aged; Phosphodiesterase 5 Inhibitors; Pyrimidines; Sulfonamides; Treatment Outcome

The purpose of this study was to investigate the therapeutic efficacy of udenafil (CAS 268203-93-6), a phosphodiesterase type 5 (PDE5) inhibitor, on bile duct ligation (BDL)-induced portal hypertension. Udenafil was given orally to rats at dose levels of 1, 5 or 25 mg/kg/day for 3 weeks in order to examine the chronic effect on portal venous pressure (PVP). Udenafil was also given orally to investigate the sequential change of PVP in BDL animals. The effect of udenafil on hepatic stellate cell activation and fibrotic change-related protein mRNA expression were examined. In a pharmacokinetic study, the pharmacokinetic parameters in sham-operated rats and BDL rats were compared. Three-week udenafil treatment decreased PVP by approximately 30% compared to the vehicle group. In a single oral administration study, the PVP of the udenafil treated group was lower than that of the control group throughout the experimental period. Compared to control, udenafil suppressed the expression of procollagen type I and alpha-smooth muscle actin mRNA. In the pharmacokinetic study, the AUC of udenafil in BDL rats was approximately 5 times higher than that in sham-operated rats. The results of this study suggest that udenafil has beneficial effects on portal hypertension and the effect may well be attributed to its anti-fibrogenic activity.

Topics: Actins; Animals; Area Under Curve; Blood Pressure; Cell Proliferation; Cell Separation; Collagen Type I; Half-Life; Hepatocytes; Hypertension, Portal; Liver; Liver Cirrhosis; Male; Phosphodiesterase 5 Inhibitors; Phosphodiesterase Inhibitors; Portal Vein; Pyrimidines; Rats; Rats, Sprague-Dawley; RNA, Messenger; Sulfonamides