Background Pulmonary arterial hypertension (PAH) is a rare disease characterised by an elevation of the pulmonary vascular resistances leading to right cardiac failure and death. Among different aetiologies of PAH, association with drug exposure was proved forty years ago with aminorex and more recently with benfluorex. Other drugs such as dasatinib or interferons seem to be associated with PAH development and/or severity. Pharmacovigilance is critical to improve our knowledge of PAH associated with drug exposure.
Purpose To confirm the feasibility of collecting the drug exposure history in PAH patients during hospitalisation by a systematic interview.
Materials and Methods This pilot study was performed in the French national PAH reference centre. Patients with idiopathic, heritable PAH, PAH known to be associated with drug exposure and pulmonary veno-occlusive disease were included. A standard questionnaire to collect the past and current medicines history was designed and approved by pharmacists and pneumologists. For each patient, this questionnaire was systematically assessed by a pharmacist after patient consent had been obtained.
Results Interviews were performed in 57 PAH patients. The median time of interview was 30 minutes. 16% of patients had a history of anorexigen exposure which led to 5 pharmacovigilance reports. The remaining four other patients were already known to the pharmacovigilance centre. Twenty seven patients (47%) had been exposed to psychoactive drugs, two patients to cytotoxic agents and one patient to interferon. Interestingly, a quarter of all patients had a history of nasal vasoconstrictor exposure.
Conclusions This pilot study demonstrates the feasibility of collecting the history of drug exposure in PAH patients during hospitalisation. Our observations match those reported in the literature except for the nasal vasoconstrictors, for which no epidemiological data have been published yet. Further studies are warranted to investigate the potential harmfulness of nasal vasoconstrictors.
No conflict of interest.
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