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DOI: 10.1055/s-2006-957199
© Georg Thieme Verlag KG Stuttgart · New York
Therapie der pulmonalarteriellen Hypertonie: Phosphodiesterase-5-Inhibitoren
Treatment of pulmonary arterial hypertension with phosphodiesterase-5 inhibitorsPublication History
eingereicht: 3.4.2006
akzeptiert: 26.10.2006
Publication Date:
30 November 2006 (online)
![](https://www.thieme-connect.de/media/dmw/2006S9/lookinside/thumbnails/10.1055-s-2006-957199-1.jpg)
Zusammenfassung
Phosphodiesterase-5(PDE5)-Inhibitoren sind ein wichtiges neues Therapieprinzip zur Behandlung der pulmonalarteriellen Hypertonie (PAH). Der selektive PDE5-Inhibitor Sildenafil führt durch Beeinflussung des NO/cGMP-Signalweges zu einer selektiven Reduktion des pulmonalvaskulären Widerstandes und verbessert die klinische Symptomatik und Leistungsfähigkeit bei PAH. Die zulassungsrelevante Phase-III-Studie (SUPER-1) hat die Effektivität und Sicherheit von Sildenafil bei PAH eindrucksvoll aufgezeigt, so dass es kürzlich für diese Indikation zugelassen wurde. Die aktuellen Leitlinien der großen Fachgesellschaften haben Sildenafil daher bereits mit einem hohen Evidenzgrad für die Behandlung der PAH aufgenommen. Sildenafil kann im Rahmen der PAH-Therapie zudem mit anderen Medikamenten kombiniert werden und hat das Potenzial zur Behandlung anderer Formen des Lungenhochdrucks.
Summary
Phosphodiesterase-5 inhibitors (PDE5I) are an important new class of drugs in the treatment of pulmonary artery hypertension (PHT). Sildenafil, a selective PDE5I, through its action on the NO/cGMP signal pathway, causes a selective reduction of pulmonary vascular resistance and improves symptoms and exercise capacity of patients with PHT. The phase III trial (SUPER-1) has clearly shown the efficacy and safety of sildenafil in PHT so that its use for this indication has recently been approved. Current guidelines of several large specialist societies have included sildenafil for the treatment of PHT, supported by a high degree of evidence. Sildenafil can also be combined with other drugs and has the potential of being efficacious also in other forms of pulmonary hypertension.
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Prof. Dr. med. H. Ardeschir Ghofrani
Medizinische Klinik II/V, Zentrum für Innere Medizin, Universitätsklinikum Giessen und Marburg
Klinikstraße 36
35392 Giessen
Email: ardeschir.ghofrani@uglc.de