Efficacy of bosentan in the treatment of pulmonary hypertension; a prospective study focusing on safety and efficacy in patients with COPD

The chronic obstructive pulmonary disease (COPD) usually results in pulmonary hypertension (PH) and about 40% of patients with COPD suffer from pulmonary hypertension during the course of their illness, that results in worsened prognosis of the disease.1,2 Some studies have defined PH as a PAP >25mm Hg.3,4 Most patients of COPD develop mild to moderate PH with only slight degree of elevation in PAP.5 PH is an essential prognostic factor in determining the course of illness in a patient suffering from COPD.5,6 In fact, some studies suggest that the severity of elevated levels of PAP is a more reliable predictor of prognosis in COPD patients in comparison to FEV1, hypoxemia or hypercapnia.6,7 It has been found that COPD patients who have PAP of >18mm Hg, are more often admitted to hospital due to exacerbations of their condition as compared to those having a mean PAP of <18mm Hg.5 The exacerbations of COPD in patients with PH are responsible for an increase in mortality and morbidity.8