PMID- 26401252
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20150924
LR  - 20200930
IS  - 2045-8932 (Print)
IS  - 2045-8940 (Electronic)
IS  - 2045-8932 (Linking)
VI  - 5
IP  - 3
DP  - 2015 Sep
TI  - Long-term therapy with oral treprostinil in pulmonary arterial hypertension 
      failed to lead to improvement in important physiologic measures: results from a 
      single center.
PG  - 513-20
LID - 10.1086/682224 [doi]
AB  - Sustained-release oral treprostinil, an oral prostacyclin, led to significant 
      improvement in 6-minute walk distance (6MWD) versus placebo in treatment-naive 
      patients with pulmonary arterial hypertension (PAH) but failed to lead to 
      significant improvement in two 16-week trials in patients receiving background 
      PAH therapies (FREEDOM studies). Long-term studies are lacking. Our objective was 
      to evaluate 6MWD, functional class, hemodynamics, and other long-term outcomes 
      during oral treprostinil administration in PAH. Patients receiving oral 
      treprostinil through the FREEDOM studies at our institution were included and 
      were followed for up to 7 years. The primary end point was change in pulmonary 
      vascular resistance (PVR) at first follow-up catheterization. Other end points 
      included 6MWD, functional class, and other hemodynamic results. Thirty-seven 
      patients received oral treprostinil for a median of 948 days, with 81%, 61%, and 
      47% continuing therapy at 1, 2, and 3 years, respectively. Mean treprostinil dose 
      at 3, 12, and 24 months was 4.3 +/- 2.3, 8.6 +/- 3.2, and 11.7 +/- 5.8 mg/24 h, 
      respectively. Compared with pretreatment values, there was no significant change 
      in 6MWD at 3 or 12 months, no improvement in functional class at 12 months, and 
      no significant change in hemodynamics at the first follow-up catheterization (N = 
      34). Oral treprostinil dose was inversely associated with change in PVR (r = 
      -0.42, P < 0.05), and change in PVR was numerically better among patients in the 
      highest dosing quartile. No significant improvement in 6MWD, functional class, or 
      hemodynamics versus pretreatment values was seen with long-term oral treprostinil 
      therapy, potentially because of inability to achieve a clinically effective dose.
FAU - Chin, Kelly Marie
AU  - Chin KM
AD  - Pulmonary and Critical Care Division, University of Texas Southwestern Medical 
      Center, Dallas, Texas, USA.
FAU - Ruggiero, Rosechelle
AU  - Ruggiero R
AD  - Pulmonary and Critical Care Division, University of Texas Southwestern Medical 
      Center, Dallas, Texas, USA.
FAU - Bartolome, Sonja
AU  - Bartolome S
AD  - Pulmonary and Critical Care Division, University of Texas Southwestern Medical 
      Center, Dallas, Texas, USA.
FAU - Velez-Martinez, Mariella
AU  - Velez-Martinez M
AD  - Cardiology Division, University of Maryland Medical Center, Baltimore, Maryland, 
      USA.
FAU - Darsaklis, Konstantina
AU  - Darsaklis K
AD  - Pulmonary and Critical Care Division, University of Texas Southwestern Medical 
      Center, Dallas, Texas, USA.
FAU - Kingman, Martha
AU  - Kingman M
AD  - Pulmonary and Critical Care Division, University of Texas Southwestern Medical 
      Center, Dallas, Texas, USA.
FAU - Harden, Scarlet
AU  - Harden S
AD  - Pulmonary and Critical Care Division, University of Texas Southwestern Medical 
      Center, Dallas, Texas, USA.
FAU - Torres, Fernando
AU  - Torres F
AD  - Pulmonary and Critical Care Division, University of Texas Southwestern Medical 
      Center, Dallas, Texas, USA.
LA  - eng
GR  - K23 HL105784/HL/NHLBI NIH HHS/United States
GR  - T32 HL098040/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PL  - United States
TA  - Pulm Circ
JT  - Pulmonary circulation
JID - 101557243
PMC - PMC4556502
OTO - NOTNLM
OT  - hemodynamics
OT  - prostacyclin
OT  - pulmonary arterial hypertension
OT  - survival
OT  - treatment
EDAT- 2015/09/25 06:00
MHDA- 2015/09/25 06:01
PMCR- 2015/09/01
CRDT- 2015/09/25 06:00
PHST- 2014/11/19 00:00 [received]
PHST- 2015/01/21 00:00 [accepted]
PHST- 2015/09/25 06:00 [entrez]
PHST- 2015/09/25 06:00 [pubmed]
PHST- 2015/09/25 06:01 [medline]
PHST- 2015/09/01 00:00 [pmc-release]
AID - PC2013216 [pii]
AID - 10.1086/682224 [doi]
PST - ppublish
SO  - Pulm Circ. 2015 Sep;5(3):513-20. doi: 10.1086/682224.