Rapid Transition from Inhaled Iloprost to Inhaled Treprostinil in Patients with Pulmonary Arterial Hypertension. Issue 1 (9th January 2013)

• Record Type: Journal Article
• Authors: Bourge, Robert C.; Tapson, Victor F.; Safdar, Zeenat; Benza, Raymond L.; Channick, Richard N.; Rosenzweig, Erika B.; Shapiro, Shelley; White, Richard James; McSwain, Christopher Shane; Gotzkowsky, Stephen Karl; Nelsen, Andrew C.; Rubin, Lewis J.
• Is Part Of: Cardiovascular therapeutics. Volume 31:Issue 1(2013:Feb.)
• Page Start: 38
• Page End: 44
• Publication Date: 2013-01-09
• Subjects: Cardiovascular pharmacology -- Periodicals; Cardiovascular agents -- Periodicals; Cardiovascular system -- Diseases -- Chemotherapy -- Periodicals; Cardiovascular Agents -- Periodicals; Cardiovascular Diseases -- drug therapy -- Periodicals; Agents cardiovasculaires -- Périodiques; Appareil cardiovasculaire -- Maladies -- Chimiothérapie -- Périodiques; 616.1005
• DOI: 10.1111/1755-5922.12008
• Languages: English
• ISSNs: 1755-5914

Abstract

<abstract abstract-type="main" id="cdr12008-abs-0001"> <title>Summary</title> <sec id="cdr12008-sec-0001" sec-type="section"> <title>Background</title> <p>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.</p> </sec> <sec id="cdr12008-sec-0002" sec-type="section"> <title>Aims</title> <p>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 μg 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.</p> </sec> <sec id="cdr12008-sec-0003" sec-type="section"> <title>Results</title> <p>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; <italic>P</italic> < 0.001), N‐terminal pro‐B‐type natriuretic peptide (−74 pg/mL; <italic>P</italic> = 0.001), and the Cambridge Pulmonary Hypertension Outcome Review (all domains <italic>P</italic> < 0.001).</p> </sec> <sec id="cdr12008-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Pulmonary arterial hypertension patients can be safely transitioned from inhaled iloprost to inhaled treprostinil while maintaining clinical status.</p> </sec> </abstract>