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Targeted therapy in pulmonary veno-occlusive disease: time for a rethink?

BACKGROUND: Pulmonary veno-occlusive disease (PVOD) is a rare condition with poor prognosis, and lung transplantation is recommended as the only curative therapy. The role of pulmonary arterial hypertension targeted therapy in PVOD remains controversial, and long-term effects of targeted therapy hav...

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Autores principales: Luo, Qin, Jin, Qi, Zhao, Zhihui, Zhao, Qing, Yu, Xue, Yan, Lu, Zhang, Yi, Xiong, Changming, Liu, Zhihong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6924010/
https://www.ncbi.nlm.nih.gov/pubmed/31856792
http://dx.doi.org/10.1186/s12890-019-1031-3
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author Luo, Qin
Jin, Qi
Zhao, Zhihui
Zhao, Qing
Yu, Xue
Yan, Lu
Zhang, Yi
Xiong, Changming
Liu, Zhihong
author_facet Luo, Qin
Jin, Qi
Zhao, Zhihui
Zhao, Qing
Yu, Xue
Yan, Lu
Zhang, Yi
Xiong, Changming
Liu, Zhihong
author_sort Luo, Qin
collection PubMed
description BACKGROUND: Pulmonary veno-occlusive disease (PVOD) is a rare condition with poor prognosis, and lung transplantation is recommended as the only curative therapy. The role of pulmonary arterial hypertension targeted therapy in PVOD remains controversial, and long-term effects of targeted therapy have been rarely reported. This study aims to retrospectively evaluate the role of targeted therapy in PVOD patients and the long-term outcome. METHODS: PVOD patients with good responses to targeted therapies were analyzed, and data pre- and post- targeted therapies were compared. An overview of the effects of targeted therapies on PVOD patients was also conducted. RESULTS: Five genetically or histologically confirmed PVOD patients received targeted therapies and showed good responses. Their mean pulmonary arterial pressure by right heart catheterization was 62.0 ± 11.7 mmHg. Two receiving monotherapy got stabilized, and three receiving sequential combination therapy got improved, cardiac function and exercise capacity significantly improved after treatments. No pulmonary edema occurred. The mean time from the first targeted therapy to the last follow up was 39.3 months, and the longest was 9 years. A systematic review regarding the effects of targeted therapies on PVOD patients indicated majorities of patients got hemodynamics or 6-min walk distance improved, and 26.7% patients developed pulmonary edema. The interval from targeted drugs use to death ranged from 71 min to over 4 years. CONCLUSIONS: Cautious use of targeted therapy could safely and effectively improve or stabilize hemodynamics and exercise capacity of some patients without any complications. PVOD patients could live longer than expected.
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spelling pubmed-69240102019-12-30 Targeted therapy in pulmonary veno-occlusive disease: time for a rethink? Luo, Qin Jin, Qi Zhao, Zhihui Zhao, Qing Yu, Xue Yan, Lu Zhang, Yi Xiong, Changming Liu, Zhihong BMC Pulm Med Research Article BACKGROUND: Pulmonary veno-occlusive disease (PVOD) is a rare condition with poor prognosis, and lung transplantation is recommended as the only curative therapy. The role of pulmonary arterial hypertension targeted therapy in PVOD remains controversial, and long-term effects of targeted therapy have been rarely reported. This study aims to retrospectively evaluate the role of targeted therapy in PVOD patients and the long-term outcome. METHODS: PVOD patients with good responses to targeted therapies were analyzed, and data pre- and post- targeted therapies were compared. An overview of the effects of targeted therapies on PVOD patients was also conducted. RESULTS: Five genetically or histologically confirmed PVOD patients received targeted therapies and showed good responses. Their mean pulmonary arterial pressure by right heart catheterization was 62.0 ± 11.7 mmHg. Two receiving monotherapy got stabilized, and three receiving sequential combination therapy got improved, cardiac function and exercise capacity significantly improved after treatments. No pulmonary edema occurred. The mean time from the first targeted therapy to the last follow up was 39.3 months, and the longest was 9 years. A systematic review regarding the effects of targeted therapies on PVOD patients indicated majorities of patients got hemodynamics or 6-min walk distance improved, and 26.7% patients developed pulmonary edema. The interval from targeted drugs use to death ranged from 71 min to over 4 years. CONCLUSIONS: Cautious use of targeted therapy could safely and effectively improve or stabilize hemodynamics and exercise capacity of some patients without any complications. PVOD patients could live longer than expected. BioMed Central 2019-12-19 /pmc/articles/PMC6924010/ /pubmed/31856792 http://dx.doi.org/10.1186/s12890-019-1031-3 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Luo, Qin
Jin, Qi
Zhao, Zhihui
Zhao, Qing
Yu, Xue
Yan, Lu
Zhang, Yi
Xiong, Changming
Liu, Zhihong
Targeted therapy in pulmonary veno-occlusive disease: time for a rethink?
title Targeted therapy in pulmonary veno-occlusive disease: time for a rethink?
title_full Targeted therapy in pulmonary veno-occlusive disease: time for a rethink?
title_fullStr Targeted therapy in pulmonary veno-occlusive disease: time for a rethink?
title_full_unstemmed Targeted therapy in pulmonary veno-occlusive disease: time for a rethink?
title_short Targeted therapy in pulmonary veno-occlusive disease: time for a rethink?
title_sort targeted therapy in pulmonary veno-occlusive disease: time for a rethink?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6924010/
https://www.ncbi.nlm.nih.gov/pubmed/31856792
http://dx.doi.org/10.1186/s12890-019-1031-3
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