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Selexipag for the treatment of chronic thromboembolic pulmonary hypertension
BACKGROUND: Treatment options for inoperable chronic thromboembolic pulmonary hypertension (CTEPH) remain limited. Selexipag, an oral selective IP prostacyclin receptor agonist approved for pulmonary arterial hypertension, is a potential treatment option for CTEPH. METHODS: In this multicentre, rand...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Respiratory Society
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9260121/ https://www.ncbi.nlm.nih.gov/pubmed/34824052 http://dx.doi.org/10.1183/13993003.01694-2021 |
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author | Ogo, Takeshi Shimokawahara, Hiroto Kinoshita, Hideyuki Sakao, Seiichiro Abe, Kohtaro Matoba, Satoaki Motoki, Hirohiko Takama, Noriaki Ako, Junya Ikeda, Yasuhiro Joho, Shuji Maki, Hisataka Saeki, Takahiro Sugano, Teruyasu Tsujino, Ichizo Yoshioka, Koichiro Shiota, Naoki Tanaka, Shinichi Yamamoto, Chieko Tanabe, Nobuhiro Tatsumi, Koichiro |
author_facet | Ogo, Takeshi Shimokawahara, Hiroto Kinoshita, Hideyuki Sakao, Seiichiro Abe, Kohtaro Matoba, Satoaki Motoki, Hirohiko Takama, Noriaki Ako, Junya Ikeda, Yasuhiro Joho, Shuji Maki, Hisataka Saeki, Takahiro Sugano, Teruyasu Tsujino, Ichizo Yoshioka, Koichiro Shiota, Naoki Tanaka, Shinichi Yamamoto, Chieko Tanabe, Nobuhiro Tatsumi, Koichiro |
author_sort | Ogo, Takeshi |
collection | PubMed |
description | BACKGROUND: Treatment options for inoperable chronic thromboembolic pulmonary hypertension (CTEPH) remain limited. Selexipag, an oral selective IP prostacyclin receptor agonist approved for pulmonary arterial hypertension, is a potential treatment option for CTEPH. METHODS: In this multicentre, randomised, double-blind, placebo-controlled study, 78 Japanese patients with inoperable CTEPH or persistent/recurrent pulmonary hypertension after pulmonary endarterectomy and/or balloon pulmonary angioplasty were randomly assigned to receive placebo or selexipag. The primary end-point was the change in pulmonary vascular resistance (PVR) from baseline to week 20. Secondary end-points were changes in other haemodynamic parameters: 6-min walk distance (6MWD), Borg dyspnoea scale score, World Health Organization (WHO) functional class, EuroQol five-dimension five-level tool and N-terminal pro-brain natriuretic peptide. RESULTS: The change in PVR was −98.2±111.3 dyn·s·cm(−5) and −4.6±163.6 dyn·s·cm(−5) in the selexipag and placebo groups, respectively (mean difference −93.5 dyn·s·cm(−5); 95% CI −156.8 to −30.3; p=0.006). The changes in cardiac index (p<0.001) and Borg dyspnoea scale score (p=0.036) were also significantly improved over placebo. 6MWD and WHO functional class were not significantly improved. The common adverse events in the selexipag group corresponded to those generally observed following administration of a prostacyclin analogue. CONCLUSION: Selexipag significantly improved PVR and other haemodynamic variables in patients with CTEPH, although exercise capacity remained unchanged. Further large-scale investigation is necessary to prove the role of selexipag in CTEPH. |
format | Online Article Text |
id | pubmed-9260121 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | European Respiratory Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-92601212022-07-08 Selexipag for the treatment of chronic thromboembolic pulmonary hypertension Ogo, Takeshi Shimokawahara, Hiroto Kinoshita, Hideyuki Sakao, Seiichiro Abe, Kohtaro Matoba, Satoaki Motoki, Hirohiko Takama, Noriaki Ako, Junya Ikeda, Yasuhiro Joho, Shuji Maki, Hisataka Saeki, Takahiro Sugano, Teruyasu Tsujino, Ichizo Yoshioka, Koichiro Shiota, Naoki Tanaka, Shinichi Yamamoto, Chieko Tanabe, Nobuhiro Tatsumi, Koichiro Eur Respir J Original Research Articles BACKGROUND: Treatment options for inoperable chronic thromboembolic pulmonary hypertension (CTEPH) remain limited. Selexipag, an oral selective IP prostacyclin receptor agonist approved for pulmonary arterial hypertension, is a potential treatment option for CTEPH. METHODS: In this multicentre, randomised, double-blind, placebo-controlled study, 78 Japanese patients with inoperable CTEPH or persistent/recurrent pulmonary hypertension after pulmonary endarterectomy and/or balloon pulmonary angioplasty were randomly assigned to receive placebo or selexipag. The primary end-point was the change in pulmonary vascular resistance (PVR) from baseline to week 20. Secondary end-points were changes in other haemodynamic parameters: 6-min walk distance (6MWD), Borg dyspnoea scale score, World Health Organization (WHO) functional class, EuroQol five-dimension five-level tool and N-terminal pro-brain natriuretic peptide. RESULTS: The change in PVR was −98.2±111.3 dyn·s·cm(−5) and −4.6±163.6 dyn·s·cm(−5) in the selexipag and placebo groups, respectively (mean difference −93.5 dyn·s·cm(−5); 95% CI −156.8 to −30.3; p=0.006). The changes in cardiac index (p<0.001) and Borg dyspnoea scale score (p=0.036) were also significantly improved over placebo. 6MWD and WHO functional class were not significantly improved. The common adverse events in the selexipag group corresponded to those generally observed following administration of a prostacyclin analogue. CONCLUSION: Selexipag significantly improved PVR and other haemodynamic variables in patients with CTEPH, although exercise capacity remained unchanged. Further large-scale investigation is necessary to prove the role of selexipag in CTEPH. European Respiratory Society 2022-07-07 /pmc/articles/PMC9260121/ /pubmed/34824052 http://dx.doi.org/10.1183/13993003.01694-2021 Text en Copyright ©The authors 2022. https://creativecommons.org/licenses/by-nc/4.0/This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org (mailto:permissions@ersnet.org) |
spellingShingle | Original Research Articles Ogo, Takeshi Shimokawahara, Hiroto Kinoshita, Hideyuki Sakao, Seiichiro Abe, Kohtaro Matoba, Satoaki Motoki, Hirohiko Takama, Noriaki Ako, Junya Ikeda, Yasuhiro Joho, Shuji Maki, Hisataka Saeki, Takahiro Sugano, Teruyasu Tsujino, Ichizo Yoshioka, Koichiro Shiota, Naoki Tanaka, Shinichi Yamamoto, Chieko Tanabe, Nobuhiro Tatsumi, Koichiro Selexipag for the treatment of chronic thromboembolic pulmonary hypertension |
title | Selexipag for the treatment of chronic thromboembolic pulmonary hypertension |
title_full | Selexipag for the treatment of chronic thromboembolic pulmonary hypertension |
title_fullStr | Selexipag for the treatment of chronic thromboembolic pulmonary hypertension |
title_full_unstemmed | Selexipag for the treatment of chronic thromboembolic pulmonary hypertension |
title_short | Selexipag for the treatment of chronic thromboembolic pulmonary hypertension |
title_sort | selexipag for the treatment of chronic thromboembolic pulmonary hypertension |
topic | Original Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9260121/ https://www.ncbi.nlm.nih.gov/pubmed/34824052 http://dx.doi.org/10.1183/13993003.01694-2021 |
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