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Withdrawal of long-term epoprostenol therapy in pulmonary arterial hypertension (PAH)
Once initiated for pulmonary arterial hypertension (PAH), epoprostenol treatment usually needs to be delivered for an indefinite duration. It is possible that some participants could be transitioned from epoprostenol to oral therapies. We retrospectively evaluated eight PAH participants transitioned...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467933/ https://www.ncbi.nlm.nih.gov/pubmed/28597752 http://dx.doi.org/10.1177/2045893217702401 |
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author | Calcaianu, George Calcaianu, Mihaela Canuet, Matthieu Enache, Irina Kessler, Romain |
author_facet | Calcaianu, George Calcaianu, Mihaela Canuet, Matthieu Enache, Irina Kessler, Romain |
author_sort | Calcaianu, George |
collection | PubMed |
description | Once initiated for pulmonary arterial hypertension (PAH), epoprostenol treatment usually needs to be delivered for an indefinite duration. It is possible that some participants could be transitioned from epoprostenol to oral therapies. We retrospectively evaluated eight PAH participants transitioned from epoprostenol to PAH oral drugs. The criteria for epoprostenol withdrawal were: (1) persistent improvement of clinic and hemodynamic status; (2) stable dose of epoprostenol for the last three months; and (3) the participant’s preference for oral therapy after evaluation of risk-benefit. We evaluated the clinical, functional, and hemodynamic status at baseline, at withdrawal, and after the transition to oral PAH therapy. The transition was completed in all eight participants. Four participants had a complete successful transition (CT) with a stable clinical and hemodynamic course and four participants had a partial successful transition (PT) remaining stable clinically, with a mild hemodynamic worsening, but without need to re-initiate epoprostenol therapy. The four CT participants were treated with epoprostenol for a shorter period of time (CT group: 35 ± 30 versus PT group: 79 ± 49 months, P = 0.08). Mean epoprostenol dosage was lower in the CT group (CT group: 15 ± 1.5 ng/kg/min versus PT group: 24 ± 11 ng/kg/min, P = 0.09). Safe withdrawal of epoprostenol treatment and transition to oral PAH therapy was possible in a small and highly selected group of participants. The majority of these participants had a porto-pulmonary PAH or PAH associated to HIV infection. |
format | Online Article Text |
id | pubmed-5467933 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-54679332017-06-20 Withdrawal of long-term epoprostenol therapy in pulmonary arterial hypertension (PAH) Calcaianu, George Calcaianu, Mihaela Canuet, Matthieu Enache, Irina Kessler, Romain Pulm Circ Research Articles Once initiated for pulmonary arterial hypertension (PAH), epoprostenol treatment usually needs to be delivered for an indefinite duration. It is possible that some participants could be transitioned from epoprostenol to oral therapies. We retrospectively evaluated eight PAH participants transitioned from epoprostenol to PAH oral drugs. The criteria for epoprostenol withdrawal were: (1) persistent improvement of clinic and hemodynamic status; (2) stable dose of epoprostenol for the last three months; and (3) the participant’s preference for oral therapy after evaluation of risk-benefit. We evaluated the clinical, functional, and hemodynamic status at baseline, at withdrawal, and after the transition to oral PAH therapy. The transition was completed in all eight participants. Four participants had a complete successful transition (CT) with a stable clinical and hemodynamic course and four participants had a partial successful transition (PT) remaining stable clinically, with a mild hemodynamic worsening, but without need to re-initiate epoprostenol therapy. The four CT participants were treated with epoprostenol for a shorter period of time (CT group: 35 ± 30 versus PT group: 79 ± 49 months, P = 0.08). Mean epoprostenol dosage was lower in the CT group (CT group: 15 ± 1.5 ng/kg/min versus PT group: 24 ± 11 ng/kg/min, P = 0.09). Safe withdrawal of epoprostenol treatment and transition to oral PAH therapy was possible in a small and highly selected group of participants. The majority of these participants had a porto-pulmonary PAH or PAH associated to HIV infection. SAGE Publications 2017-03-13 /pmc/articles/PMC5467933/ /pubmed/28597752 http://dx.doi.org/10.1177/2045893217702401 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc/3.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Research Articles Calcaianu, George Calcaianu, Mihaela Canuet, Matthieu Enache, Irina Kessler, Romain Withdrawal of long-term epoprostenol therapy in pulmonary arterial hypertension (PAH) |
title | Withdrawal of long-term epoprostenol therapy in pulmonary arterial hypertension (PAH) |
title_full | Withdrawal of long-term epoprostenol therapy in pulmonary arterial hypertension (PAH) |
title_fullStr | Withdrawal of long-term epoprostenol therapy in pulmonary arterial hypertension (PAH) |
title_full_unstemmed | Withdrawal of long-term epoprostenol therapy in pulmonary arterial hypertension (PAH) |
title_short | Withdrawal of long-term epoprostenol therapy in pulmonary arterial hypertension (PAH) |
title_sort | withdrawal of long-term epoprostenol therapy in pulmonary arterial hypertension (pah) |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467933/ https://www.ncbi.nlm.nih.gov/pubmed/28597752 http://dx.doi.org/10.1177/2045893217702401 |
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