Extract
Prostacyclin analogues targeting the prostacyclin pathway are used to treat patients with pulmonary arterial hypertension (PAH), and are given either by an intravenous, subcutaneous or inhaled route [1]. Continuous i.v. infusion of epoprostenol has received the strongest recommendation for treatment of the most severe forms of PAH [2], mainly because it is the only PAH-specific drug that was demonstrated to give an improvement in survival in a randomised controlled study [3]. Due to drawbacks associated with its i.v. administration, epoprostenol is preferentially offered to young, high-risk patients [2]. For PAH patients in New York Heart Association (NYHA) functional class (FC) III/IV with severe haemodynamic impairment, epoprostenol can be combined with an endothelin receptor antagonist (ERA) and a phosphodiesterase type-5 (PDE-5) inhibitor to achieve sustained clinical and haemodynamic efficacy [4, 5].
Abstract
Even for patients who are very stable while receiving i.v. epoprostenol over a long period of time, any transition to selexipag warrants careful long-term clinical and haemodynamic follow-up because worsening is likely to occur http://bit.ly/32wR9eX
Footnotes
Conflict of interest: K. Yanaka has nothing to disclose.
Conflict of interest: A. Guillien has nothing to disclose.
Conflict of interest: T. Soumagne has nothing to disclose.
Conflict of interest: J. Benet has nothing to disclose.
Conflict of interest: N. Piliero has nothing to disclose.
Conflict of interest: F. Picard has nothing to disclose.
Conflict of interest: C. Pison reports grants and personal fees from GlaxoSmithKline, personal fees from Novartis Pharma, Boehringer Ingelheim and AstraZeneca, outside the submitted work.
Conflict of interest: O. Sitbon reports personal fees from Arena Pharmaceuticals, Acceleron Pharmaceuticals and Gossamer Bio, personal fees and non-financial support from Actelion Pharmaceuticals, grants and personal fees from Bayer HealthCare and Merck, non-financial support from GlaxoSmithKline, outside the submitted work.
Conflict of interest: H. Bouvaist reports grants and non-financial support from GlaxoSmithKline and Bayer HealthCare, personal fees and non-financial support from Actelion Pharmaceuticals, outside the submitted work.
Conflict of interest: B. Degano reports personal fees and non-financial support from Actelion Pharmaceuticals, non-financial support from Bayer HealthCare, grants, personal fees and non-financial support from Novartis Pharma, personal fees from Chiesi, GlaxoSmithKline and Menarini, outside the submitted work.
- Received December 16, 2019.
- Accepted February 16, 2020.
- Copyright ©ERS 2020
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