What is the efficacy of iloprost for the treatment of pulmonary arterial hypertension (PAH)?

Updated: Apr 25, 2018
  • Author: Kristin E Schwab, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Iloprost is a chemically synthetic analogue of prostacyclin that dilates systemic and pulmonary arterial vascular beds. It can be delivered through an inhaler by producing aerosol particles that deposit in the alveoli. It is indicated for patients with NYHA class III or IV symptoms to improve exercise tolerance and symptoms and to delay deterioration. A 12-week trial involving 203 patients showed an increase in patient scores on a 6-minute walk test and an improvement in NYHA functional class, as well as improved hemodynamics. [46] The long-term efficacy of inhaled iloprost remains disappointing because the only trials performed exhibited a high dropout rate and no improvement in survival compared with conventional therapy. [46, 47] Adverse effects include cough, hypotension, and syncope associated with vasodilation. Its disadvantage is its short duration of action. Therefore, it must be inhaled as many as six times a day.


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