|
 |
|
|||||||
|
|||||||||
Copyright ©ERS Journals Ltd 2006
Long-term outcome in pulmonary arterial hypertension patients treated with subcutaneous treprostinil
1 Columbia University College of Physicians and Surgeons, New York, NY, 5 United Therapeutics Corporation, Research Triangle Park, NC, and, 6 University of California, San Diego, School of Medicine, La Jolla, CA, USA, 2 Institute of Cardiology, University of Bologna, Bologna, Italy, 3 Erasmus University Hospital, Brussels, Belgium, and 4 Hospital Antoine Beclere, Clamart, France.
CORRESPONDENCE: R. J. Barst, Columbia University College of Physicians and Surgeons, 3959 Broadway, BHN 2-255, New York, NY 10032, USA. Fax: 1 2123421443. E-mail: rjb3{at}columbia.edu
Keywords: Idiopathic pulmonary arterial hypertension, prostacyclin analogue, pulmonary arterial hypertension, survival, treprostinil
Received: March 30, 2006
Accepted July 25, 2006
Pulmonary arterial hypertension (PAH) is fatal if untreated. Intravenous epoprostenol improves exercise capacity and haemodynamics in PAH, and increases survival in idiopathic PAH (IPAH). To evaluate the effects of subcutaneous (SC) treprostinil, a longer-acting prostacyclin analogue, followed by the addition of other PAH therapies if needed, 860 PAH patients treated with SC treprostinil for up to 4 yrs were followed.
Survival is reported as Kaplan–Meier estimates. For 332 IPAH patients with baseline haemodynamics, observed survival is also compared with predicted survival using the National Institute of Health formula.
Out of the 860 patients, 199 (23%) discontinued due to adverse events, 136 (16%) died, 117 (14%) discontinued due to deterioration, 29 (3%) withdrew consent and 11 (1%) underwent transplantation. In total, 97 patients (11%) switched from SC treprostinil to an alternative prostacyclin analogue; bosentan was added in 105 patients (12%) and sildenafil in 25 (3%).
In conclusion, survival was 87–68% over 1–4 yrs for all 860 patients and 88–70% over 1–4 yrs with subcutaneous treprostinil monotherapy. For the idiopathic pulmonary arterial hypertension subset with baseline haemodynamics (n = 332), survival was 91–72% over 1–4 yrs. In contrast, predicted survival was 69–38% over 1–4 yrs. The safety profile for long-term subcutaneous treprostinil was consistent with previous short-term trials with no unexpected adverse events.
This article has been cited by other articles:
|
|
 |
|
  M. Delcroix, K. Spaas, and R. Quarck Long-term outcome in pulmonary arterial hypertension: a plea for earlier parenteral prostacyclin therapy Eur. Respir. Rev., December 1, 2009; 18(114): 253 - 259. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 The Task Force for the Diagnosis and Treatment of, N. Galie, M. M. Hoeper, M. Humbert, A. Torbicki, J-L. Vachiery, J. A. Barbera, M. Beghetti, P. Corris, S. Gaine, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension Eur. Respir. J., December 1, 2009; 34(6): 1219 - 1263. [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Oudiz, N. Galie, H. Olschewski, F. Torres, A. Frost, H. A. Ghofrani, D. B. Badesch, M. D. McGoon, V. V. McLaughlin, E. B. Roecker, et al. Long-term ambrisentan therapy for the treatment of pulmonary arterial hypertension. J. Am. Coll. Cardiol., November 17, 2009; 54(21): 1971 - 1981. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, N. Galie, M. M. Hoeper, M. Humbert, A. Torbicki, J.-L. Vachiery, J. A. Barbera, M. Beghetti, P. Corris, S. Gaine, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: The Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT) Eur. Heart J., October 2, 2009; 30(20): 2493 - 2537. [Full Text] [PDF]
|
|
|
|
|
|
V. V. McLaughlin, S. L. Archer, D. B. Badesch, R. J. Barst, H. W. Farber, J. R. Lindner, M. A. Mathier, M. D. McGoon, M. H. Park, R. S. Rosenson, et al. ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension: A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association Developed in Collaboration With the American College of Chest Physicians; American Thoracic Society, Inc.; and the Pulmonary Hypertension Association J. Am. Coll. Cardiol., April 28, 2009; 53(17): 1573 - 1619. [Full Text] [PDF]
|
|
|
|
 |
|
 Writing Committee Members, V. V. McLaughlin, S. L. Archer, D. B. Badesch, R. J. Barst, H. W. Farber, J. R. Lindner, M. A. Mathier, M. D. McGoon, M. H. Park, et al. ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension: A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association: Developed in Collaboration With the American College of Chest Physicians, American Thoracic Society, Inc., and the Pulmonary Hypertension Association Circulation, April 28, 2009; 119(16): 2250 - 2294. [Full Text] [PDF]
|
|
|
|
 |
|
 M. D. McGoon and G. C. Kane Pulmonary Hypertension: Diagnosis and Management Mayo Clin. Proc., February 1, 2009; 84(2): 191 - 207. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Galiè and A. Manes CHAPTER 24 Pulmonary Hypertension ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Boutet, D. Montani, X. Jais, A. Yaici, O. Sitbon, G. Simonneau, and M. Humbert Review: Therapeutic advances in pulmonary arterial hypertension Therapeutic Advances in Respiratory Disease, August 1, 2008; 2(4): 249 - 265. [Abstract] [PDF]
|
|
|
|
 |
|
 R. L. Benza, B. K. Rayburn, J. A. Tallaj, S. V. Pamboukian, and R. C. Bourge Treprostinil-Based Therapy in the Treatment of Moderate-to-Severe Pulmonary Arterial Hypertension: Long-term Efficacy and Combination With Bosentan Chest, July 1, 2008; 134(1): 139 - 145. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. MacKnight, E. A. Martinez, and B. A. Simon Anesthetic Management of Patients With Pulmonary Hypertension Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2008; 12(2): 91 - 96. [Abstract] [PDF]
|
|
|
|
|
|
M. Gomberg-Maitland and H. Olschewski Prostacyclin therapies for the treatment of pulmonary arterial hypertension Eur. Respir. J., April 1, 2008; 31(4): 891 - 901. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 National Pulmonary Hypertension Centres of the UK Consensus statement on the management of pulmonary hypertension in clinical practice in the UK and Ireland Heart, March 1, 2008; 94(Suppl_1): i1 - i41. [Full Text] [PDF]
|
|
|
|
 |
|
 National Pulmonary Hypertension Centres of the UK Consensus statement on the management of pulmonary hypertension in clinical practice in the UK and Ireland Thorax, March 1, 2008; 63(Suppl_2): ii1 - ii41. [Full Text] [PDF]
|
|
|
|
 |
|
 I. M. Lang Management of acute and chronic RV dysfunction Eur. Heart J. Suppl., December 1, 2007; 9(suppl_H): H61 - H67. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. C. Widlitz, S. McDevitt, G. R. Ward, and A. Krichman Practical Aspects of Continuous Intravenous Treprostinil Therapy Crit. Care Nurse, April 1, 2007; 27(2): 41 - 50. [Full Text] [PDF]
|
|
|
|
|
|
S. Provencher Long-term treprostinil in pulmonary arterial hypertension: is the glass half full or half empty? Eur. Respir. J., December 1, 2006; 28(6): 1073 - 1075. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |