Pulmonary Arterial Hypertension (“PAH”) is a rare condition that affects 1-2 people per million globally. There are several potential causes of PAH, but as of now, no known cure. One of the causes of pulmonary arterial hypertension is diet drugs and specifically diet drugs that contain fenfluramine.
The Merman Law Firm has handled PAH cases from the east coast to the west coast. Mr. Merman is intimately familiar with the science and history of PAH caused by diet drugs. Mr. Merman has collected millions of dollars for people who contracted PAH as a result of taking diet drugs. If you or a loved one has PAH that you believe may have been caused by ingesting diet drugs, contact the Merman Law Firm for a free evaluation.
The Science of Drug-Induced PAH
Pulmonary arterial hypertension is a progressive, often fatal disease involving complex vascular changes in the pulmonary vasculature that ultimately result in progressive injury of the pulmonary arterial vessels and the development of pulmonary arterial hypertension. Extensive, ongoing research over the last three decades has identified several pathophysiologic processes that play a role in the development of PPH in an individual and has also allowed identification of risk factors for the disease. Most of the research on the causal link between PAH and anorectics followed the International Primary Pulmonary Hypertension Study (IPPHS), conducted from 1992-1994.
The IPPHS was a prospective case-control study which assessed 95 patients with PAH from France, Belgium, the United Kingdom, and the Netherlands and 355 controls matched by the patient's’ sex and age. The clinical data for this study were collected between September 1992 and December 1994. After the study, a detailed, preliminary disclosure of results was made in March 1995. This report was requested by the European Health Agency. The results derived from that analysis reflected an odds ratio of 6.3 between the use of anorexigens and the development of PPH. These results supported the conclusion of a causal relationship.
These results also included a determination of the incidence of the disease, which allowed the researchers to compute that the absolute risk of PAH associated with long-term use of anorexigens (greater than one year) in obese persons was 1 per 10,000 or 100 per million. This should be contrasted with the background incidence of 1-2 cases per million in the unexposed population. This, in simple terms, means that the odds of contracting PAH increases by 100X or 10,000% if anorexigens are prescribed and used for more than one year.
The final report of July 1996, and in the published New England Journal of medicine article, the consistency of the observations with previous findings, the magnitude of the association, the fact that the risk of developing PPH increases with longer use, and the fact that the association is stronger with recent use than with past use all favor a causal relationship. The totality of medical and scientific data supports the causal relationship between anorectic use and PPH beyond any doubt and is among the most powerful associations described in the medical literature between a medication and a disease. The PAH lawyers at the Merman Law Firm understand the science behind drug-induced PAH – Mr. Merman has a degree in biology and has handled many PAH cases with great success.
Diet Drug PAH - Treatment, Cost and Prognosis
While there are medical and surgical treatments for PPH, none is without significant cost, adverse effects and potentially serious complications. In the early stages of PPH, treatments usually consist of chronic anticoagulation, calcium channel blockers in patients who demonstrate an acute response to vasodilator challenge on catheterization, and diuretics to control the congestive heart failure and edema associated with the disease. Once these more conservative measures fail to adequately control symptoms and pulmonary artery pressures, therapy with bosentan, prostacyclin or prostacyclin analogs must be instituted. Flolan must be administered by continuous intravenous infusion via a pump delivery system the patient must wear 24 hours a day. The dose must be increased and titrated according to the patient’s response and symptoms. Flolan therapy is extremely expensive and cumbersome for patients and is associated with noxious, unpleasant side effects. However, it remains the only alternative medical therapy in most instances.
The only surgical treatment available for PPH patients is heart-lung or lung transplantation, though this is considered a “last hope” option in most cases only after prostacyclin therapy fails to manage the disease. Once a patient is determined to need a transplant, the waiting time is variable and there is a high percentage of candidates who die waiting. The transplantation procedure itself is associated with serious complications such as bleeding, infection, and rejection. In fact, all patients experience some degree of rejection and post-transplant care involves careful monitoring for rejection and management of immunosuppressive therapy to minimize this complication.
In summary, PAH is a devastating, progressive, frequently disabling disease for which there are some treatments, but no cure. Though survival has been improved with currently available treatments, life expectancy with this disease is shortened, though to what degree in an individual patient is impossible to predict with certainty. However, given the requirements for expensive, lifelong therapy attendant with the diagnosis of PAH, the improvement in survival seen with currently available therapy, and ongoing research directed at improving survival further with new medical treatments, it is imperative that patients plan for a near normal life expectancy and the financial means to secure treatments necessary to sustain their lives for the duration.
If you have PAH, you are no doubt aware of the prognosis and the financial cost of treatment. You are also aware of the impact that the disease will have on you and your family. You need the best PAH lawyer to represent you against the drug companies or they will take advantage and blame you for the disease. The compassionate, experienced PAH lawyers at the Merman Law Firm know how to handle these cases and the drug companies. Call the PAH lawyers at the Merman Law Firm to discuss your case.