The Pulmonary Vascular Research Institute (PVRI), an international non-profit research organization devoted to advancing the awareness and treatment of pulmonary vascular diseases, held its 6th Annual General Meeting and 5th Scientific Workshops and Debate meeting on February 7-10th, 2012, in Cape Town, South Africa. International experts gathered to present new information on the global burden of Pulmonary Hypertension (PH) and new advances in the management of the disease. On 7 February, as a precursor to the meetings, the PVRI convened a media roundtable co-chaired by a panel of leading international experts in cardiovascular medicine to provide expert opinion and insight into recent information regarding the burden and treatment of pulmonary hypertension.
Pathogenesis and progression of pulmonary hypertension
Pulmonary hypertension affects more than 25 million people globally, said Prof. Ghazwan Butrous, the head of the division of Cardiopulmonary Sciences at the University of Kent, Canterbury, UK and the Managing Director of the PVRI. He explained that pulmonary hypertension is a severe, rapidly progressive and irreversible disease that affects people of all ages, races, and socioeconomic groups. The disease is difficult to detect, and diagnosis is often delayed until disease progression is advanced. Sadly the disease is not curable, but early diagnosis and urgent, individualized treatment significantly improves quality of life and prolongs survival. Without treatment the median survival for patients with idiopathic pulmonary arterial hypertension is only 2.8 years, and when associated with chronic obstructive airways disease, less than 50% of the patients survive beyond one year. Prof Butrous concluded by emphasizing that clinicians should maintain a high level of suspicion and consider pulmonary hypertension as a differential diagnosis in patients who present with dyspnea, dizziness, syncope, fatigue and cyanosis and do not respond to conventional therapies for left sided heart failure.
The burden of Pulmonary Hypertension in Sub-Saharan Africa
Prof. Karen Sliwa, a professor of Cardiovascular Research at the Hatter Institute for Cardiovascular Research Institute in Africa (HICRA) and Institute of Infectious Disease and Molecular Medicine at the University of Cape Town in South Africa, revealed that there is limited data on the epidemiology and characteristics of Pulmonary Hypertension in Sub-Saharan Africa. Lack of awareness on the disease and the poor accessibility to healthcare in Africa invariably leads to late diagnosis of the precursors of pulmonary hypertension. This is further compounded by the shortage of physicians, lack of awareness on PH among the physicians as well as lack of specialized centers for the diagnosis and treatment of the disease. Prof Sliwa added that a multi-country Pan African Pulmonary Hypertension Cohort Study (PAPUCO) was launched in 2010 to describe the epidemiology and characteristics of pulmonary hypertension in Sub-Saharan Africa. A cohort of five hundred participants newly diagnosed with pulmonary hypertension in 17 cardiovascular specialist centres in 8 African countries was enrolled in the first year of the study. Each participant has been started on treatment for PH and will be followed up for a period of six months to evaluate outcomes in terms of symptom scores and selected biological markers. PAPUCO is the first Pan African cohort study to use a web-based data capturing platform. The platform was developed by Integerafrica, a medical research information management consultancy registered in South Africa. The study will run until April 2013. (For more information on the study visit the webpage: https://s3.integerafrica.org/).
New advances in the management of PH
The prognosis for patients with PH has improved in recent years, said Prof. Hosseni A. Ghofrani, the head of the Pulmonary Hypertension Division in the Department of Internal Medicine at Giessen University in Germany. Chronic Thromboembolic Pulmonary Hypertension (CTEPH) is potentially curable through surgery and pulmonary endarterectomy is the preferred procedure. However CTEPH becomes inoperable when the thrombi are surgically inaccessible or when the patient is deemed unfit for surgery due to co-morbid diseases. Prof Ghofrani drew attention to some recent advances in medical science that have led to the approval of several medicines for treating PH, though he acknowledged that all of them have significant limitations. With drugs that are currently available on the market, the main treatment goals are to improve the patientís quality of life and to lengthen their survival time. Prof Ghofrani also revealed that a promising novel drug known as Riociguat (a soluble guanylate cyclase [sGC] stimulator) is currently in advanced phase III clinical trials for the treatment of pulmonary arterial hypertension (PAH) and CTEPH. Recently completed phase II trials showed that the drug has a potential to significantly improve clinical and hemodynamic parameters among patients. The drug has also demonstrated a potential to offer effective treatment approaches across other types of PH.
Bayer Healthcare is contributing to the fight against pulmonary hypertension
The meeting was co-hosted by Bayer Health Care, one of the leading companies in the field of pharmaceutical and medical products globally. Bayer is working in partnership with the pulmonary hypertension community to improve the management of pulmonary hypertension, through research and development of new treatments, as well as raising awareness and understanding of the devastating impacts of the disease, said Dr. Rahul Agrawal, a Cardiologist with Bayer HealthCare. Riociguat is one of the most advanced candidate drugs being investigated by Bayer for the treatment of various forms of PH. If clinical trials are successful the new drug could be registered as early as 2013 in the United States of America.
More information on Pulmonary Hypertension and the work being done by the Pulmonary Vascular Research Institute (PVRI) can be found on the following websites:
By Dr Lazarus Kuonza, Editor of the Pan African Medical Journal (PAMJ)
News - Published on 31-Aug-2012