Author reply to technical comment

Reply to comment by Carratù P, et al. on: Hostettler K, et al. Bosentan for patients with steroid-resistant pulmonary sarcoidosis: a randomised controlled trial

DOI: https://doi.org/10.4414/smw.2019.20133
Publication Date: 30.09.2019
Swiss Med Wkly. 2019;149:w20133

Hostettler Katrin E.a, Brutsche Martin H.b

a Clinics of Respiratory Medicine, University Hospital Basel, Switzerland

b Division of Pulmonary Medicine, Cantonal Hospital St Gallen, Switzerland

We thank Carratù et al. for their technical comment [1] on our publication about the effect of bosentan in patients with steroid-resistant pulmonary sarcoidosis [2]. The authors have shown previously that endothelin-1 (ET-1) urine levels were significantly higher in patients with active sarcoidosis as compared with healthy controls [3]. Furthermore, urine ET-1 levels decreased after prednisone treatment, which was paralleled by an improved clinical status [3]. Based on this observation the authors suggest measuring urine ET-1 levels before and after bosentan treatment, as this might be a prognostic factor.

The identification of specifically targetable traits in a complex disorder like sarcoidosis is of paramount importance. However, we would like to emphasise that the role of ET-1 urine levels in patients with sarcoidosis has not been elucidated yet and thus it is rather speculative to propose it as a prognostic tool. Neither has it been validated as a predictive tool. Moreover, based on our data [2] and on current knowledge there is no role for bosentan in the treatment of patients with steroid-resistant pulmonary sarcoidosis and thus the effect of bosentan on urine ET-1 levels in sarcoidosis patients does not seem of priority interest.

Disclosure statement

No financial support and no other potential conflict of interest relevant to this article was reported.

Credits

Header image: © Bradcalkins | Dreamstime.com

Correspondence

Katrin E. Hostettler, MD, PhD, University Hospital Basel, Petersgraben 4, CH-4031 Basel, katrin.hostettler[at]usb.ch

References

1 Carratù P, Dragonieri S, Resta O. Comment on: Hostettler K, et al. Bosentan for patients with steroid-resistant pulmonary sarcoidosis: a randomised controlled trial. Swiss Med Wkly. 2019;149:w20132. doi: http://dx.doi.org/10.4414/smw.2019.20132

2 Hostettler K, Baty F, Kleiner R, Junker L, Tamm M, Brutsche M. Bosentan for patients with steroid-resistant pulmonary sarcoidosis: a randomised controlled trial. Swiss Med Wkly. 2018;148:w14677. doi:. http://dx.doi.org/10.4414/smw.2018.14677 PubMed

3 Sofia M, Mormile M, Faraone S, Alifano M, Carratù P, Carratù L. Endothelin-1 excretion in urine in active pulmonary sarcoidosis and in other interstitial lung diseases. Sarcoidosis. 1995;12(2):118–23. PubMed

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