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PPH and Fen-Phen: What We Know so Far

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Los Angels, CAFen-Phen (a diet drug combination of phentermine and either Pondimin and Redux) has been linked to an increased risk of Primary Pulmonary Hypertension (PPH).

Fen Phen was an appetite suppressor used by people who were trying to lose weight in the 1990s. It was withdrawn from the market in 1997 after the drug combination was linked to heart valve problems. Additionally, some studies have shown that exposure to appetite suppressants can increase the risk of PPH by 25 to 30 percent.

Studies conducted in 1996 showed that people who took Fen-Phen had a significantly higher risk of developing PPH. The greatest risk was to people who took the drugs for three months or longer, although even people who took Fen-Phen for a month are at an increased risk of side effects.

Primary Pulmonary Hypertension

Hypertension refers to blood pressure that is too high. Pulmonary hypertension is high blood pressure in the pulmonary artery. In patients with PPH the blood pressure in the pulmonary artery is higher than 25 mm Hg at rest and higher than 30 mm Hg during exertion.

Primary pulmonary hypertension is high blood pressure in the pulmonary artery that cannot be explained (it is sometimes referred to as unexplained pulmonary hypertension). In this case, there is no apparent reason for the blood pressure to be so high.

The pulmonary artery carries oxygen-poor blood from the heart to the lungs where it picks up oxygen. The blood then moves back to the heart from which it is pumped to the rest of the body carrying the oxygen. People with PPH have extra resistance to blood flowing through the lungs, forcing the heart to work harder to pump the blood through the lungs.

According to the American Heart Association, between 500 and 1,000 new cases of PPH are diagnosed every year. Those most at risk of developing PPH are women between the ages of 20 and 40; however PPH has been known to develop in anyone, including young children.

Although it is not known what causes primary pulmonary hypertension, appetite suppressants, cocaine, and HIV are all factors that have been linked to the onset of PPH.

Treatment of Primary Pulmonary Hypertension

There are a variety of drugs that lower the blood pressure in patients' lungs; however not all drugs work equally well on every patient. Often, patients are required to try a number of drugs before one is found that works best on each individual.

The types of drugs include:

• Calcium channel-blocking drugs given orally,
• Intravenous prostacyclin (vasodilator),
• Anticoagulants, and
• Diuretics

Some patients with more severe forms of PPH require oxygen masks to help them breathe. Additionally, patients who do not respond to medicine may require organ transplants (lung or heart-lung).

Prognosis

If primary pulmonary hypertension is caught early the patient can often return to an almost normal lifestyle, including physical activity. Unfortunately, PPH is difficult to diagnose early because it progresses slowly and its symptoms are often mistaken for simply being out of shape.

Because PPH is a disease in which the cause is unknown, doctors must first exclude any other possible causes of the pulmonary hypertension before actually diagnosing the patient as having PPH. The average time from onset to diagnosis has been reported to be around two years although in some cases it can take as many as ten years to obtain a diagnosis.

Furthermore, PPH is not curable it is only treatable, meaning that once a patient has developed PPH, he or she will have it for life. If a patient with PPH goes untreated, he or she will eventually suffer heart failure and die.

Lawsuits

Lawsuits have already been filed in individual cases against Wyeth, makers of Fen-Phen. Late last year, five women diagnosed with PPH filed complaints against the company alleging that their use of Fen-Phen resulted in the development of the disease. In one case, there was almost a decade from the time the victim took the drug to the time PPH was diagnosed. That patient required a dual-lung transplant to treat the disease.

In her complaint, the victim accuses Wyeth of intentionally misleading consumers about the risk of PPH associated with taking Fen-Phen.

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