CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 2, March 2012
120
AFRICA
Recruitment of pulmonary hypertension patients for PATENT trial
with RIOCIQUAT completed
Sub-Saharan pulmonary hypertension study launched
The first-ever clinical trial of an agent to
treat both pulmonary arterial hyperten-
sion (PAH) and chronic thrombo-embolic
pulmonary hypertension (CTEPH) has
completed recruitment. This landmark
development was announced in Cape
Town recently at a Bayer Healthcare
media conference, held to coincide with
an international meeting of the Pulmonary
Vascular Research Institute (PVRI), an
expert, non-profit global organisation.
The PATENT trial is a phase III clini-
cal trial of RIOCIQUAT, a promising
novel drug, in development by Bayer
Healthcare. Prof Hossein Ghofrani
(University Hospital, Giessen and
Marburg, Germany) described the devel-
opment of RIOCIQUAT as very prom-
ising: ‘RIOCIQUAT has shown very
encouraging data in pre-clinical and
phase II trials’, he noted. ‘This will be the
first medical treatment for patients with
PAH and those with CTEPH, the latter
condition currently only treatable with
vascular surgery to remove the clots in the
pulmonary vasculature.’
Prof Karen Sliwa of the University of
Cape Town’s Hatter Institute announced
the commencement of the first sub-Saha-
ran study of pulmonary hypertension,
involving 10 countries, including South
Africa.
Cameroon, Kenya, Mozambique,
Nigeria, Rwanda, Sudan, Tanzania,
Uganda and Zimbabwe are collabo-
rating in the Pan-African Pulmonary
Hypertension Cohort study which has
already started recruitment. Using novel
web-based protocol support, the study
aims to recruit 500 patients from 18
cardiovascular specialist centres in these
countries
).
‘We know very little about this deadly
disease in sub-Saharan Africa and we
have no data on outcomes and life expec-
tancy in these patients in Africa’, she
noted. ‘Limited reports suggest that the
incidence is higher in Africa, owing to
the pattern of diseases prevalent on the
continent’, she said.
High incidences of schistosomiasis,
HIV, chronic hepatitis B and C, sickle
cell disease, tuberculosis and mining-
related lung disease predispose to the
development of pulmonary hypertension.
‘Improved understanding of the demo-
graphics, natural history and survival of
African patients is key to the effective
management of pulmonary hypertension
and to ensure the most effective treatment
options are available to those who need
them’, she concluded.
J Aalbers
It's the
shell that
makes
safer.
R
Safety-Coated
R
81mg
The ORIGINAL low dose aspirin
for optimum cardio-protection
Hp
Each tablet contains Aspirin 81mg. Reg.No.: 29/2.7/0767
Pharmafrica (Pty) Ltd, 33 Hulbert Road, New Centre, Johannesburg 2001
Under licence from Goldshield Pharmaceuticals Ltd. U.K.
•
Higher C-reactive protein (CRP) levels
are associated with higher vascular risk
but CRP adds little additional informa-
tion to conventional risk assessment.
•
In the face of muscle symptoms, the
clinician needs to assess if they are
statin induced or not. A good starting
point is to stop the statin (de-challenge).
Patients with statin-induced myalgia
usually report a rapid improvement in
symptoms. Hypothyroidism and other
causes of muscle pain (fibromyalgia,
osteomalacia, etc) need to be excluded.
Statin myalgia is often dose related,
and patients may be able to tolerate
a lower statin dose. An alternative
statin can be tried, particularly if the
patient is on other medication that may
interact with the first statin. Alternate
day (or even less frequent) statins
have no outcome evidence but can be
considered if statin myalgia is a major
problem. Ezetimibe is useful to boost
the efficacy of a low-dose statin and
occasionally is used as monotherapy
in patients who are completely statin
intolerant.
•
LDL cholesterol levels are sufficient
for diagnosis and therapy and there is
no need to routinely measure ApoB in
everyday clinical practice.
J Aalbers
1.
ESC/EAS guidelines for the management of
dyslipidaemias.
Eur Heart J
2011;
32
(14):
1769–1818.
2.
Preiss D, Sattan N. Statins and the risk
of new-onset diabetes: a review of recent
evidence.
Curr Opin Lipidol
2011;
22
(6):
460–468.
