Comparison of Tadalafil and Sildenafil in Controlling Neonatal Persistent Pulmonary Hypertension

Background: Persistent pulmonary hypertension of the newborn (PPHN) occurs in post-term neonates with an incidence of 1 in 500 - 1,500 live births. The survival rate is approximately 69% after conventional management of infants suffering from PPHN. Extracorporeal membrane oxygenation (ECMO) therapy improves survival up to 86%.
Methods: A total of 32 neonates with PPHN participated in this study. These neonates were randomly assigned into two 16-case groups: group A received tadalafil while group B received sildenafil. A random simple sampling method was used for the selection of subjects. The severity of tricuspid regurgitation (TR), main pulmonary artery (MPA) diameter, mean pulmonary artery pressure (MPAP), and right ventricular end-diastolic diameter (RVEDD) were assessed by echocardiography before and 6 months after treatment.
Results: MPAP decreased after treatment in both groups, but the mean of changes in PAP in the two groups was not significantly different (P = 0.48). Both tadalafil and sildenafil significantly reduced the TR severity, RVEDD, and MPA diameter (P < 0.05), but the mean of the changes in TR, RVEDD, and MPA in both groups was similar (P = 0.05).
Conclusions: Tadalafil and sildenafil can similarly reduce MPAP, TR severity, RVEDD, and MPA diameter.