Does rapid dose titration affect the hepatic safety profile of Bosentan?
Author(s): Suntharalingam J, Hodgkins D, Cafferty FH, Hughes RJ, Pepke-Zaba J Affiliation(s): Clinical Research Fellow, Pulmonary Vascular Diseases Unit, Papworth Hospital NHS Trust, Papworth Everard, Cambridgeshire, CB3 8RE, United Kingdom. jay.suntharalingam@papworth.nhs.uk Publication date & source: 2006-06, Vascul Pharmacol., 44(6):508-12. Epub 2006 May 19. Publication type: Clinical Trial RATIONALE: Bosentan, a dual endothelin receptor antagonist, has proven efficacy in pulmonary hypertension. Due to an association with hepatic dysfunction, it is typically initiated at a sub-therapeutic dose for 4 weeks before titration to a therapeutic dose. At our institution some patients have undergone rapid titration, to potentially benefit from therapy earlier. This study assesses the impact of this practice on hepatic safety. METHOD: All patients initiated on bosentan therapy before April 2005 were included. Rapidly titrated patients achieved a therapeutic dose by 3 days, whereas standard t