Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
John Cavenagh, PhD, PA-C
Objective: The objective of this systematic review is to determine whether or not the oral Phosphodiesterase inhibitor Tadalafil improves exercise capacitance in those over 12 years with pulmonary hypertension.
Study Design: Review of three primary research materials published in English language in 2009. Data Sources: Randomized, controlled, double blind clinical trials found using PubMed, OVID and COCHRANE databases.
Outcome measured: Trials measured 6-minute walking distance and health related quality of life measurements which included: SF-36 (a measure of self reported health status), and the EQ-5D (a patient reported health related quality of life measure), WHO functional class, clinical worsening, and hemodynamic measurements.
Results: Two of the randomized controlled trials included in this review showed that tadalafil is effective at improving exercise capacitance in patients with pulmonary hypertension. The trials showed patients had an improvement in their 6-minute walking distance, self reported health status and quality of life, and improvement in time to clinical worsening. The trial conducted by Fischler et al showed that tadalafil was not effective at improving exercise capacitance in patients with high altitude pulmonary edema in comparison with dexamethasone.
Conclusions: Tadalafil 40 mg is an effective monotherapy for increasing exercise capacitance and improving health related quality of life in patients with pulmonary hypertension. In the Galie et al and Pepke-Zaba et al studies, tadalafil was found to improve exercise capacitance and quality of life in patients with pulmonary arterial hypertension. However, in the Fischler et al study, dexamethasone, not tadalafil improved exercise capacity in patients with high al2titude pulmonary edema.
Chesnavich, Erin, "Does Tadalafil Improve Exercise Capacitance in Patients over 12 Years Old with Pulmonary Hypertension?" (2012). PCOM Physician Assistant Studies Student Scholarship. 65.