PMID- 21119185
OWN - NLM
STAT- MEDLINE
DCOM- 20110317
LR  - 20221115
IS  - 1600-0617 (Electronic)
IS  - 0905-9180 (Print)
IS  - 0905-9180 (Linking)
VI  - 19
IP  - 118
DP  - 2010 Dec
TI  - Treat-to-target strategies in pulmonary arterial hypertension: the importance of 
      using multiple goals.
PG  - 272-8
LID - 10.1183/09059180.00008210 [doi]
AB  - Major advances have occurred in the treatment of pulmonary arterial hypertension 
      (PAH) over the past decade. The advent of PAH-specific pharmacological treatments 
      has offered hope to patients with a debilitating, progressive disease and a poor 
      prognosis. Combined drug treatment offers improved benefits over monotherapy, and 
      current treatment guidelines for PAH recommend a sequential add-on approach to 
      combination therapy for patients in New York Heart Association (NYHA)/World 
      Health Organization functional class (WHO FC) II-IV. Goal-oriented therapy 
      determines the timing of treatment escalation by inadequate response to known 
      prognostic indicators. Close monitoring of patients aids the early identification 
      of inadequate response, so that treatment can be escalated promptly and before 
      the patient's condition deteriorates further. Existing treatment goals are based 
      on baseline values of prognostic indicators, but it is vital to identify risk 
      factors that are both relevant during treatment and that can be assessed during 
      follow-up appointments. Data from different PAH aetiologies indicate that 
      NYHA/WHO FC is the most appropriate prognostic marker, with 6-min walk distance 
      and several haemodynamic parameters representing alternatives. Future refinement 
      of goal-oriented therapy could include the use of multiple prognostic markers, 
      while additional, large clinical trials will answer questions concerning choice 
      and combination of treatment goals.
FAU - Sitbon, O
AU  - Sitbon O
AD  - Hopital Antoine Beclere, Universite Paris-Sud 11, Clamart, France. 
      olivier.sitbon@abc.aphp.fr
FAU - Galie, N
AU  - Galie N
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - England
TA  - Eur Respir Rev
JT  - European respiratory review : an official journal of the European Respiratory 
      Society
JID - 9111391
SB  - IM
MH  - Humans
MH  - Hypertension, Pulmonary/*diagnosis/*therapy
MH  - *Patient Care Planning
MH  - Prognosis
MH  - Risk Factors
MH  - Treatment Outcome
PMC - PMC9487504
COIS- Statement of Interest O. Sitbon has relationships with drug companies including 
      Actelion, Bayer Schering, GSK, Lilly, Pfizer and United Therapeutics, in addition 
      to being an investigator in trials involving these companies relationships 
      include consultancy service and membership of scientific advisory boards. He has 
      received reimbursement for attending symposium and funds for research from 
      Actelion, Pfizer, GSK, Lilly and Bayer Schering. He has received fees for 
      speaking from Actelion, Bayer Schering, GSK, Lilly, Pfizer and United 
      Therapeutics. N. Galie reports having served on the advisory boards of Pfizer, 
      Actelion, Schering, Encysive, Myogen, GSK, Eli Lilly and Mondobiotech and having 
      been paid lecture fees by Actelion and Schering. He reports that his institute 
      has received grant support from Pfizer, Actelion, Schering, Encysive, United 
      Therapeutics, Eli-Lilly, Mondobiotec and Myogen.
EDAT- 2010/12/02 06:00
MHDA- 2011/03/18 06:00
PMCR- 2010/12/01
CRDT- 2010/12/02 06:00
PHST- 2010/12/02 06:00 [entrez]
PHST- 2010/12/02 06:00 [pubmed]
PHST- 2011/03/18 06:00 [medline]
PHST- 2010/12/01 00:00 [pmc-release]
AID - 19/118/272 [pii]
AID - err0082-2010 [pii]
AID - 10.1183/09059180.00008210 [doi]
PST - ppublish
SO  - Eur Respir Rev. 2010 Dec;19(118):272-8. doi: 10.1183/09059180.00008210.