Cargando…
Combined use of ursodeoxycholic acid and bosentan prevents liver toxicity caused by endothelin receptor antagonist bosentan monotherapy: two case reports
INTRODUCTION: Pulmonary arterial hypertension is a fatal disease characterized by progressive remodeling of the pulmonary arteries and an increase in pulmonary vascular resistance. Up to 50% of patients with systemic sclerosis have pulmonary arterial hypertension, which significantly affects the pro...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4107936/ https://www.ncbi.nlm.nih.gov/pubmed/25015229 http://dx.doi.org/10.1186/1752-1947-8-250 |
_version_ | 1782327678080122880 |
---|---|
author | Ito, Tomoki Ozaki, Yoshio Son, Yonsu Nishizawa, Tohru Amuro, Hideki Tanaka, Akihiro Tamaki, Takeshi Nomura, Shosaku |
author_facet | Ito, Tomoki Ozaki, Yoshio Son, Yonsu Nishizawa, Tohru Amuro, Hideki Tanaka, Akihiro Tamaki, Takeshi Nomura, Shosaku |
author_sort | Ito, Tomoki |
collection | PubMed |
description | INTRODUCTION: Pulmonary arterial hypertension is a fatal disease characterized by progressive remodeling of the pulmonary arteries and an increase in pulmonary vascular resistance. Up to 50% of patients with systemic sclerosis have pulmonary arterial hypertension, which significantly affects the prognosis. The endothelin receptor antagonist bosentan is used for the treatment of pulmonary arterial hypertension and shows a great beneficial effect. However, the most frequent side effect of bosentan is liver toxicity, which often requires dose reduction and discontinuation. CASE PRESENTATION: We report two cases (a 64-year-old Japanese woman and a 69-year old Japanese woman) of systemic sclerosis, both with severe Raynaud’s phenomenon and pulmonary arterial hypertension. Both patients had initially received bosentan monotherapy, which caused liver toxicity as indicated by increased levels of alanine aminotransferase, alkaline phosphatase, and gamma-glutamyltransferase. After dose reduction or discontinuation of bosentan, these liver function abnormalities were normalized and the patients subsequently received retreatment with a combination of bosentan and ursodeoxycholic acid. The results of liver function tests did not show any abnormalities after this combination therapy. CONCLUSIONS: These reports suggest the usefulness of ursodeoxycholic acid for preventing liver toxicity caused by bosentan. Thus, the addition of ursodeoxycholic acid to the treatment protocol is expected to be useful when liver toxicity emerges as a side effect of bosentan. |
format | Online Article Text |
id | pubmed-4107936 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-41079362014-07-24 Combined use of ursodeoxycholic acid and bosentan prevents liver toxicity caused by endothelin receptor antagonist bosentan monotherapy: two case reports Ito, Tomoki Ozaki, Yoshio Son, Yonsu Nishizawa, Tohru Amuro, Hideki Tanaka, Akihiro Tamaki, Takeshi Nomura, Shosaku J Med Case Rep Case Report INTRODUCTION: Pulmonary arterial hypertension is a fatal disease characterized by progressive remodeling of the pulmonary arteries and an increase in pulmonary vascular resistance. Up to 50% of patients with systemic sclerosis have pulmonary arterial hypertension, which significantly affects the prognosis. The endothelin receptor antagonist bosentan is used for the treatment of pulmonary arterial hypertension and shows a great beneficial effect. However, the most frequent side effect of bosentan is liver toxicity, which often requires dose reduction and discontinuation. CASE PRESENTATION: We report two cases (a 64-year-old Japanese woman and a 69-year old Japanese woman) of systemic sclerosis, both with severe Raynaud’s phenomenon and pulmonary arterial hypertension. Both patients had initially received bosentan monotherapy, which caused liver toxicity as indicated by increased levels of alanine aminotransferase, alkaline phosphatase, and gamma-glutamyltransferase. After dose reduction or discontinuation of bosentan, these liver function abnormalities were normalized and the patients subsequently received retreatment with a combination of bosentan and ursodeoxycholic acid. The results of liver function tests did not show any abnormalities after this combination therapy. CONCLUSIONS: These reports suggest the usefulness of ursodeoxycholic acid for preventing liver toxicity caused by bosentan. Thus, the addition of ursodeoxycholic acid to the treatment protocol is expected to be useful when liver toxicity emerges as a side effect of bosentan. BioMed Central 2014-07-11 /pmc/articles/PMC4107936/ /pubmed/25015229 http://dx.doi.org/10.1186/1752-1947-8-250 Text en Copyright © 2014 Ito et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Ito, Tomoki Ozaki, Yoshio Son, Yonsu Nishizawa, Tohru Amuro, Hideki Tanaka, Akihiro Tamaki, Takeshi Nomura, Shosaku Combined use of ursodeoxycholic acid and bosentan prevents liver toxicity caused by endothelin receptor antagonist bosentan monotherapy: two case reports |
title | Combined use of ursodeoxycholic acid and bosentan prevents liver toxicity caused by endothelin receptor antagonist bosentan monotherapy: two case reports |
title_full | Combined use of ursodeoxycholic acid and bosentan prevents liver toxicity caused by endothelin receptor antagonist bosentan monotherapy: two case reports |
title_fullStr | Combined use of ursodeoxycholic acid and bosentan prevents liver toxicity caused by endothelin receptor antagonist bosentan monotherapy: two case reports |
title_full_unstemmed | Combined use of ursodeoxycholic acid and bosentan prevents liver toxicity caused by endothelin receptor antagonist bosentan monotherapy: two case reports |
title_short | Combined use of ursodeoxycholic acid and bosentan prevents liver toxicity caused by endothelin receptor antagonist bosentan monotherapy: two case reports |
title_sort | combined use of ursodeoxycholic acid and bosentan prevents liver toxicity caused by endothelin receptor antagonist bosentan monotherapy: two case reports |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4107936/ https://www.ncbi.nlm.nih.gov/pubmed/25015229 http://dx.doi.org/10.1186/1752-1947-8-250 |
work_keys_str_mv | AT itotomoki combineduseofursodeoxycholicacidandbosentanpreventslivertoxicitycausedbyendothelinreceptorantagonistbosentanmonotherapytwocasereports AT ozakiyoshio combineduseofursodeoxycholicacidandbosentanpreventslivertoxicitycausedbyendothelinreceptorantagonistbosentanmonotherapytwocasereports AT sonyonsu combineduseofursodeoxycholicacidandbosentanpreventslivertoxicitycausedbyendothelinreceptorantagonistbosentanmonotherapytwocasereports AT nishizawatohru combineduseofursodeoxycholicacidandbosentanpreventslivertoxicitycausedbyendothelinreceptorantagonistbosentanmonotherapytwocasereports AT amurohideki combineduseofursodeoxycholicacidandbosentanpreventslivertoxicitycausedbyendothelinreceptorantagonistbosentanmonotherapytwocasereports AT tanakaakihiro combineduseofursodeoxycholicacidandbosentanpreventslivertoxicitycausedbyendothelinreceptorantagonistbosentanmonotherapytwocasereports AT tamakitakeshi combineduseofursodeoxycholicacidandbosentanpreventslivertoxicitycausedbyendothelinreceptorantagonistbosentanmonotherapytwocasereports AT nomurashosaku combineduseofursodeoxycholicacidandbosentanpreventslivertoxicitycausedbyendothelinreceptorantagonistbosentanmonotherapytwocasereports |