Experimental design of the Effects of Dehydroepiandrosterone in Pulmonary Hypertension (EDIPHY) trial
Pulmonary arterial hypertension (PAH) remains life-limiting despite numerous approved vasodilator therapies. Right ventricular (RV) function determines outcome in PAH but no treatments directly target RV adaptation. PAH is more common in women, yet women have better RV function and survival as compa...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-05-01
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| Series: | Pulmonary Circulation |
| Online Access: | https://doi.org/10.1177/2045894021989554 |
| _version_ | 1811230551645880320 |
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| author | Thomas P. Walsh Grayson L. Baird Michael K. Atalay Saurabh Agarwal Daniel Arcuri James R. Klinger Christopher J. Mullin Heather Morreo Brynn Normandin Sruti Shiva Mary Whittenhall Corey E. Ventetuolo |
| author_facet | Thomas P. Walsh Grayson L. Baird Michael K. Atalay Saurabh Agarwal Daniel Arcuri James R. Klinger Christopher J. Mullin Heather Morreo Brynn Normandin Sruti Shiva Mary Whittenhall Corey E. Ventetuolo |
| author_sort | Thomas P. Walsh |
| collection | DOAJ |
| description | Pulmonary arterial hypertension (PAH) remains life-limiting despite numerous approved vasodilator therapies. Right ventricular (RV) function determines outcome in PAH but no treatments directly target RV adaptation. PAH is more common in women, yet women have better RV function and survival as compared to men with PAH. Lower levels of the adrenal steroid dehydroepiandrosterone (DHEA) and its sulfate ester are associated with more severe pulmonary vascular disease, worse RV function, and mortality independent of other sex hormones in men and women with PAH. DHEA has direct effects on nitric oxide (NO) and endothelin-1 (ET-1) synthesis and signaling, direct antihypertrophic effects on cardiomyocytes, and mitigates oxidative stress. Effects of Dehydroepiandrosterone in Pulmonary Hypertension (EDIPHY) is an on-going randomized double-blind placebo-controlled crossover trial of DHEA in men ( n = 13) and pre- and post-menopausal women ( n = 13) with Group 1 PAH funded by the National Heart, Lung and Blood Institute. We will determine whether orally administered DHEA 50 mg daily for 18 weeks affects RV longitudinal strain measured by cardiac magnetic resonance imaging, markers of RV remodeling and oxidative stress, NO and ET-1 signaling, sex hormone levels, other PAH intermediate end points, side effects, and safety. The crossover design will elucidate sex-based phenotypes in PAH and whether active treatment with DHEA impacts NO and ET-1 biosynthesis. EDIPHY is the first clinical trial of an endogenous sex hormone in PAH. Herein we present the study’s rationale and experimental design. |
| first_indexed | 2024-04-12T10:30:19Z |
| format | Article |
| id | doaj.art-5558b45d3b2a4d208b72f3220157e92b |
| institution | Directory Open Access Journal |
| issn | 2045-8940 |
| language | English |
| last_indexed | 2024-04-12T10:30:19Z |
| publishDate | 2021-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Circulation |
| spelling | doaj.art-5558b45d3b2a4d208b72f3220157e92b2022-12-22T03:36:52ZengWileyPulmonary Circulation2045-89402021-05-011110.1177/2045894021989554Experimental design of the Effects of Dehydroepiandrosterone in Pulmonary Hypertension (EDIPHY) trialThomas P. WalshGrayson L. BairdMichael K. AtalaySaurabh AgarwalDaniel ArcuriJames R. KlingerChristopher J. MullinHeather MorreoBrynn NormandinSruti ShivaMary WhittenhallCorey E. VentetuoloPulmonary arterial hypertension (PAH) remains life-limiting despite numerous approved vasodilator therapies. Right ventricular (RV) function determines outcome in PAH but no treatments directly target RV adaptation. PAH is more common in women, yet women have better RV function and survival as compared to men with PAH. Lower levels of the adrenal steroid dehydroepiandrosterone (DHEA) and its sulfate ester are associated with more severe pulmonary vascular disease, worse RV function, and mortality independent of other sex hormones in men and women with PAH. DHEA has direct effects on nitric oxide (NO) and endothelin-1 (ET-1) synthesis and signaling, direct antihypertrophic effects on cardiomyocytes, and mitigates oxidative stress. Effects of Dehydroepiandrosterone in Pulmonary Hypertension (EDIPHY) is an on-going randomized double-blind placebo-controlled crossover trial of DHEA in men ( n = 13) and pre- and post-menopausal women ( n = 13) with Group 1 PAH funded by the National Heart, Lung and Blood Institute. We will determine whether orally administered DHEA 50 mg daily for 18 weeks affects RV longitudinal strain measured by cardiac magnetic resonance imaging, markers of RV remodeling and oxidative stress, NO and ET-1 signaling, sex hormone levels, other PAH intermediate end points, side effects, and safety. The crossover design will elucidate sex-based phenotypes in PAH and whether active treatment with DHEA impacts NO and ET-1 biosynthesis. EDIPHY is the first clinical trial of an endogenous sex hormone in PAH. Herein we present the study’s rationale and experimental design.https://doi.org/10.1177/2045894021989554 |
| spellingShingle | Thomas P. Walsh Grayson L. Baird Michael K. Atalay Saurabh Agarwal Daniel Arcuri James R. Klinger Christopher J. Mullin Heather Morreo Brynn Normandin Sruti Shiva Mary Whittenhall Corey E. Ventetuolo Experimental design of the Effects of Dehydroepiandrosterone in Pulmonary Hypertension (EDIPHY) trial Pulmonary Circulation |
| title | Experimental design of the Effects of Dehydroepiandrosterone in Pulmonary Hypertension (EDIPHY) trial |
| title_full | Experimental design of the Effects of Dehydroepiandrosterone in Pulmonary Hypertension (EDIPHY) trial |
| title_fullStr | Experimental design of the Effects of Dehydroepiandrosterone in Pulmonary Hypertension (EDIPHY) trial |
| title_full_unstemmed | Experimental design of the Effects of Dehydroepiandrosterone in Pulmonary Hypertension (EDIPHY) trial |
| title_short | Experimental design of the Effects of Dehydroepiandrosterone in Pulmonary Hypertension (EDIPHY) trial |
| title_sort | experimental design of the effects of dehydroepiandrosterone in pulmonary hypertension ediphy trial |
| url | https://doi.org/10.1177/2045894021989554 |
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