PMID- 22970909
OWN - NLM
STAT- MEDLINE
DCOM- 20130624
LR  - 20220321
IS  - 1755-5922 (Electronic)
IS  - 1755-5914 (Print)
IS  - 1755-5914 (Linking)
VI  - 31
IP  - 1
DP  - 2013 Feb
TI  - Rapid transition from inhaled iloprost to inhaled treprostinil in patients with 
      pulmonary arterial hypertension.
PG  - 38-44
LID - 10.1111/1755-5922.12008 [doi]
AB  - BACKGROUND: Inhaled treprostinil is a prostacyclin analog approved for the 
      treatment of pulmonary arterial hypertension (PAH) that may provide a more 
      convenient treatment option for patients receiving inhaled iloprost while 
      maintaining the clinical benefit of inhaled prostacyclin therapy. AIMS: In this 
      open-label safety study, 73 PAH patients were enrolled with primarily World 
      Health Organization Class II (56%) or III (42%) symptoms. At baseline, most 
      patients (93%) were receiving 5 mug of iloprost per dose but 38% of patients 
      reported a dosing frequency below the labeled rate of 6-9 times daily. Patients 
      initiated inhaled treprostinil at 3 breaths four times daily (qid) at the 
      immediate next scheduled iloprost dose. The primary objective was to assess the 
      safety of rapid transition from iloprost to inhaled treprostinil; clinical status 
      and quality of life were also assessed. RESULTS: Most patients (84%) achieved the 
      target treprostinil dose of 9 breaths qid and remained on study until transition 
      to commercial therapy (89%). The most frequent adverse events (AEs) were cough 
      (74%), headache (44%), and nausea (30%), and five patients prematurely 
      discontinued study drug due to AE (n = 3), disease progression (n = 1), or death 
      (n = 1). At week 12, the time spent on daily treatment activities was reduced 
      compared to baseline, with a mean total savings of 1.4 h per day. Improvements 
      were also observed at week 12 for 6-min walk distance (+16.0; P < 0.001), 
      N-terminal pro-B-type natriuretic peptide (-74 pg/mL; P = 0.001), and the 
      Cambridge Pulmonary Hypertension Outcome Review (all domains P < 0.001). 
      CONCLUSIONS: Pulmonary arterial hypertension patients can be safely transitioned 
      from inhaled iloprost to inhaled treprostinil while maintaining clinical status.
CI  - (c) 2012 Blackwell Publishing Ltd.
FAU - Bourge, Robert C
AU  - Bourge RC
AD  - University of Alabama at Birmingham, Birmingham, AL 35294, USA. bbourge@uab.edu
FAU - Tapson, Victor F
AU  - Tapson VF
FAU - Safdar, Zeenat
AU  - Safdar Z
FAU - Benza, Raymond L
AU  - Benza RL
FAU - Channick, Richard N
AU  - Channick RN
FAU - Rosenzweig, Erika B
AU  - Rosenzweig EB
FAU - Shapiro, Shelley
AU  - Shapiro S
FAU - White, R James
AU  - White RJ
FAU - McSwain, Christopher Shane
AU  - McSwain CS
FAU - Gotzkowsky, Stephen Karl
AU  - Gotzkowsky SK
FAU - Nelsen, Andrew C
AU  - Nelsen AC
FAU - Rubin, Lewis J
AU  - Rubin LJ
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - England
TA  - Cardiovasc Ther
JT  - Cardiovascular therapeutics
JID - 101319630
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Vasodilator Agents)
RN  - DCR9Z582X0 (Epoprostenol)
RN  - JED5K35YGL (Iloprost)
RN  - RUM6K67ESG (treprostinil)
SB  - IM
MH  - Administration, Inhalation
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Antihypertensive Agents/*administration & dosage/adverse effects/pharmacokinetics
MH  - Arterial Pressure/*drug effects
MH  - Drug Administration Schedule
MH  - *Drug Substitution
MH  - Epoprostenol/administration & dosage/adverse effects/*analogs & 
      derivatives/pharmacokinetics
MH  - Familial Primary Pulmonary Hypertension
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/diagnosis/*drug therapy/physiopathology
MH  - Iloprost/*administration & dosage/adverse effects/pharmacokinetics
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Pulmonary Artery/*drug effects/physiopathology
MH  - Quality of Life
MH  - Time Factors
MH  - Treatment Outcome
MH  - United States
MH  - Vasodilation/*drug effects
MH  - Vasodilator Agents/*administration & dosage/adverse effects/pharmacokinetics
MH  - Young Adult
PMC - PMC3561685
EDAT- 2012/09/14 06:00
MHDA- 2013/06/26 06:00
CRDT- 2012/09/14 06:00
PHST- 2012/09/14 06:00 [entrez]
PHST- 2012/09/14 06:00 [pubmed]
PHST- 2013/06/26 06:00 [medline]
AID - 10.1111/1755-5922.12008 [doi]
PST - ppublish
SO  - Cardiovasc Ther. 2013 Feb;31(1):38-44. doi: 10.1111/1755-5922.12008.