PMID- 18690755
OWN - NLM
STAT- MEDLINE
DCOM- 20090106
LR  - 20181025
IS  - 1175-3277 (Print)
IS  - 1175-3277 (Linking)
VI  - 8
IP  - 4
DP  - 2008
TI  - The role of treprostinil in the management of pulmonary hypertension.
PG  - 213-7
AB  - Pulmonary arterial hypertension (PAH) is a severely disabling disorder 
      characterized by sustained elevations of pulmonary vascular resistance, 
      ultimately leading to right-heart failure and death. Intravenous epoprostenol has 
      been widely used in patients with PAH, leading to long-term clinical benefits and 
      improved survival. Epoprostenol has to be delivered through a permanently 
      implanted intravenous catheter, with the potential of life-threatening 
      complications. Thus, treprostinil, a stable prostacyclin analog suitable for 
      subcutaneous administration, has been developed. Treprostinil is chemically 
      stable at room temperature, has a long half-life (2-4 hours), and has similar 
      pharmacologic properties with comparable hemodynamic effects as epoprostenol.A 
      large, double-blind, placebo-controlled, multicenter, 12-week study confirmed the 
      efficacy of subcutaneous treprostinil, by improving exercise capacity, Borg 
      Dypnea Score (BDS), New York Heart Association (NYHA) class, and clinical signs 
      and symptoms in patients with PAH. Subsequently, multiple observational studies 
      reported the long-term effects of subcutaneous treprostinil. The long-term 
      survival of patients treated with subcutaneous treprostinil was similar to that 
      reported with intravenous epoprostenol. Pain at the infusion site has been a 
      major drawback of subcutaneous treprostinil, hampering dose titration and leading 
      to an 8-10% discontinuation rate. In addition, studies have examined the efficacy 
      of intravenous treprostinil in the treatment of patients with PAH. An open-label 
      study demonstrated that intravenous treprostinil improved exercise capacity, BDS, 
      NYHA functional class, and hemodynamics at week 12 compared with baseline. 
      Transitioning from intravenous epoprostenol to intravenous treprostinil is safe 
      and effective. The dose of intravenous treprostinil has to be adjusted to 
      approximately twice the dose of intravenous epoprostenol. Most patients have 
      reported less severe adverse effects with intravenous treprostinil compared with 
      intravenous epoprostenol. The assessment of the long-term efficacy and safety of 
      continuous intravenous treprostinil requires further studies.
FAU - Skoro-Sajer, Nika
AU  - Skoro-Sajer N
AD  - Department of Internal Medicine II, Division of Cardiology, Vienna General 
      Hospital, Medical University of Vienna, Wahringer Gurtel 18-20, Vienna, Austria.
FAU - Lang, Irene
AU  - Lang I
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - New Zealand
TA  - Am J Cardiovasc Drugs
JT  - American journal of cardiovascular drugs : drugs, devices, and other 
      interventions
JID - 100967755
RN  - 0 (Antihypertensive Agents)
RN  - DCR9Z582X0 (Epoprostenol)
RN  - RUM6K67ESG (treprostinil)
SB  - IM
MH  - Antihypertensive Agents/*administration & dosage/adverse effects/pharmacokinetics
MH  - Clinical Trials as Topic
MH  - Epoprostenol/administration & dosage/adverse effects/*analogs & 
      derivatives/pharmacokinetics
MH  - Humans
MH  - Hypertension, Pulmonary/classification/*drug therapy/physiopathology
MH  - Injections, Intravenous
MH  - Injections, Subcutaneous
MH  - Survival Rate
EDAT- 2008/08/12 09:00
MHDA- 2009/01/07 09:00
CRDT- 2008/08/12 09:00
PHST- 2008/08/12 09:00 [pubmed]
PHST- 2009/01/07 09:00 [medline]
PHST- 2008/08/12 09:00 [entrez]
AID - 841 [pii]
AID - 10.2165/00129784-200808040-00001 [doi]
PST - ppublish
SO  - Am J Cardiovasc Drugs. 2008;8(4):213-7. doi: 10.2165/00129784-200808040-00001.