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Transition from selexipag to oral treprostinil in a patient with pulmonary arterial hypertension

Prostacyclins are the mainstay treatment for patients with severe pulmonary arterial hypertension. This case highlights the transition from selexipag to oral treprostinil. Our patient improved both subjectively and objectively. Cardiac output and index, as measured by the echocardiogram, improved 12...

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Autores principales: Oriaku, Ifeoma, Patel, Amol, Safdar, Zeenat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144673/
https://www.ncbi.nlm.nih.gov/pubmed/32292582
http://dx.doi.org/10.1177/2045894019898032
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author Oriaku, Ifeoma
Patel, Amol
Safdar, Zeenat
author_facet Oriaku, Ifeoma
Patel, Amol
Safdar, Zeenat
author_sort Oriaku, Ifeoma
collection PubMed
description Prostacyclins are the mainstay treatment for patients with severe pulmonary arterial hypertension. This case highlights the transition from selexipag to oral treprostinil. Our patient improved both subjectively and objectively. Cardiac output and index, as measured by the echocardiogram, improved 12% and 7.7%, respectively. Invasive hemodynamic data revealed greater improvements: cardiac output improved by 25% and cardiac index by 28%. Mixed venous oxygen saturation improved from 65% to 71%. A possible explanation is that selexipag has a maximal dose, whereas there is no recommended maximum dose of oral treprostinil. Another theory is oral treprostinil has higher affinity to the IP receptor, though selexipag has a higher specificity. However, there are no bio-equivalency data, and data comparing pharmacodynamics of both drugs are lacking. Furthermore, no head-to-head trials comparing these agents exist.
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spelling pubmed-71446732020-04-14 Transition from selexipag to oral treprostinil in a patient with pulmonary arterial hypertension Oriaku, Ifeoma Patel, Amol Safdar, Zeenat Pulm Circ Case Report Prostacyclins are the mainstay treatment for patients with severe pulmonary arterial hypertension. This case highlights the transition from selexipag to oral treprostinil. Our patient improved both subjectively and objectively. Cardiac output and index, as measured by the echocardiogram, improved 12% and 7.7%, respectively. Invasive hemodynamic data revealed greater improvements: cardiac output improved by 25% and cardiac index by 28%. Mixed venous oxygen saturation improved from 65% to 71%. A possible explanation is that selexipag has a maximal dose, whereas there is no recommended maximum dose of oral treprostinil. Another theory is oral treprostinil has higher affinity to the IP receptor, though selexipag has a higher specificity. However, there are no bio-equivalency data, and data comparing pharmacodynamics of both drugs are lacking. Furthermore, no head-to-head trials comparing these agents exist. SAGE Publications 2020-04-08 /pmc/articles/PMC7144673/ /pubmed/32292582 http://dx.doi.org/10.1177/2045894019898032 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) 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 Case Report
Oriaku, Ifeoma
Patel, Amol
Safdar, Zeenat
Transition from selexipag to oral treprostinil in a patient with pulmonary arterial hypertension
title Transition from selexipag to oral treprostinil in a patient with pulmonary arterial hypertension
title_full Transition from selexipag to oral treprostinil in a patient with pulmonary arterial hypertension
title_fullStr Transition from selexipag to oral treprostinil in a patient with pulmonary arterial hypertension
title_full_unstemmed Transition from selexipag to oral treprostinil in a patient with pulmonary arterial hypertension
title_short Transition from selexipag to oral treprostinil in a patient with pulmonary arterial hypertension
title_sort transition from selexipag to oral treprostinil in a patient with pulmonary arterial hypertension
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144673/
https://www.ncbi.nlm.nih.gov/pubmed/32292582
http://dx.doi.org/10.1177/2045894019898032
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