{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:54:44Z","timestamp":1787500484435,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T00:00:00Z","timestamp":1641168000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the safety and tolerability of treatment with ambrisentan and tadalafil in pediatric pulmonary hypertension (PH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>This retrospective observational two\u2010center study included subjects (\u226418 years of age) with PH receiving combination therapy with ambrisentan and tadalafil. Before initiating this therapy, many patients were on other therapies for PH. At baseline, patients either received no therapy or monotherapy with a phosphodiesterase 5 inhibitor (PDE5i) or endothelin receptor antagonist (ERA) (Group A), switched from a different PDE5i and ERA (Group B), or were on prostanoid therapy with or without a PDE5i and\/or ERA (Group C and D). Demographics, symptoms, and adverse effects were collected. Pre\u2010 and postvalues for exercise capacity, hemodynamics, and biomarkers were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 43 subjects (26 F, 17 M) ages 4\u201317.5 years (median 9.3) with World Symposium of PH group 1, 3, and 5. Significant improvements were seen in change scores at follow\u2010up in the entire sample and Group A for 6\u2010min walk distance: +37.0 (6.5\u201371.0) [\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022], mean pulmonary artery pressure: \u22126.0 (\u221214.0 to \u22123.5) [\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.002], pulmonary vascular resistance: \u22121.7 (\u22126.2 to \u22121.0) [\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.003], NT\u2010proBNP \u221232.9 (\u2212148.9 to \u22126.7) [\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.025]. WHO functional class improved in 39.5% and was unchanged in 53.5%; PH\u00a0risk scores improved in 16%; were unchanged in 56%; and declined in 14%. Three patients discontinued therapy (two headaches, one peripheral edema). Seven patients were hospitalized for worsening disease (2\/7 had a Potts shunt placed, 2\/7 had an atrial septostomy). There were no deaths or lung transplantation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Combination therapy with ambrisentan and tadalafil was well\u2010tolerated, with an acceptable safety profile in a select group of children. This therapy was associated with improved exercise capacity and hemodynamics in children who were treatment na\u00efve or on monotherapy with a PH medication before the initiation of ambrisentan and tadalafil. Based on these early data, further study of combination therapy in pediatric PH is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.25796","type":"journal-article","created":{"date-parts":[[2021,12,18]],"date-time":"2021-12-18T02:34:20Z","timestamp":1639794860000},"page":"724-733","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Safety and tolerability of combination therapy with ambrisentan and tadalafil for the treatment of pulmonary arterial hypertension in children: Real\u2010world experience"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5776-1375","authenticated-orcid":false,"given":"Azadeh","family":"Issapour","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology Columbia University Irving Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Frank","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology University of Colorado, Children's Hospital Colorado Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Crook","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Columbia University Irving Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle D.","family":"Hite","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology University of Colorado, Children's Hospital Colorado Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle L.","family":"Dorn","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Columbia University Irving Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika B.","family":"Rosenzweig","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Columbia University Irving Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Dunbar","family":"Ivy","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology University of Colorado, Children's Hospital Colorado Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usha S.","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Columbia University Irving Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/children5040044"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00056110"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1413687"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01916-2018"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv317"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx257"},{"key":"e_1_2_9_8_1","volume-title":"The Harriet Lane Handbook","author":"Hughes H","year":"2017"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.22555"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.10.031"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00007314"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00007-2017"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02043-2015"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0085-2016"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/17476348.2019.1565998"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.10.028"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.02.575"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.839274"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-012-0180-4"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-013-0840-z"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2003.11.030"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.742510"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.12.051"},{"key":"e_1_2_9_24_1","unstructured":"Letairis\u00ae (ambrisentan) [package insert]. 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