Chinwe Unegbu, M.D., is an assistant professor in the Division of Anesthesiology, Pain and Perioperative Medicine at Children's National Health System and first author of a study that found the use of PDE-5 inhibitors in pediatrics is safe to treat pulmonary hypertension. Photo courtesy of Children's National Health System
Feb. 24 (UPI) -- A review of research has shown that the use of phosphodiesterase type 5, or PDE-5, inhibitors are safe for treating pulmonary hypertension in infants and children.
Pulmonary hypertension, or PH, is a type of high blood pressure that affects arteries in the heart and lungs. Patients with PH have increased pressure in the pulmonary arteries, which carry blood from the heart to the lungs. Changes in the arteries make it harder for the heart to pump blood to the lungs over time, forcing the heart to work harder. This leads to less blood flow from the right to left side of the heart, which can impact the kidneys, liver and other organs.
"Pediatricians across the nation view the rise of pediatric pulmonary hypertension [PH] cases with growing concern because the disease can worsen, leading to right ventricular failure and death," Dr. Chinwe Unegbu, assistant professor in the Division of Anesthesiology, Pain and Perioperative Medicine at Children's National Health System and first author of the study, said in a press release.
"PH can occur in newborns, infants and children who have a number of health conditions, including congenital heart disease, the most common birth defect among newborns. There are few available treatments for the growing population of children affected by this condition, so it is heartening that the evidence supports PDE-5 inhibitors for patients with PH."
Researchers from Johns Hopkins University reviewed the Medline, Embase, SCOPUS and Cochrane Central Register of Controlled Trials for use of PDE-5 inhibitors in pediatric patients with primary and secondary PH.
The researchers identified 1,270 studies, with 21, including eight controlled trials, meeting the criteria for the review. Children in the studies ranged in age from preterm to adolescence.
"Although there is some risk associated with PDE-5 inhibitor use by pediatric patients with PH, overwhelmingly the data indicate the benefits of using this class of drugs far outweigh the risks," Unegbu said. "When we looked at specific clinical outcomes, we see definite improvement in a number of measures including oxygenation, hemodynamics and better clinical outcomes. The patients are doing better, feeling better and their exercise capacity rises."
Researchers also examined the toxicity data associated with PDE-5 inhibitors.
"With the exception of a single trial, the remaining trials included in our review did not demonstrate increased mortality in patients placed on this class of medicines, which was reassuring to us," Unegbu said. "We can say with a good degree of confidence that providers should feel fairly comfortable prescribing PDE-5 inhibitors."
The study was published in Pediatrics.
