Abstract | BACKGROUND: METHODS: We studied 14 patients on long-term subcutaneous treprostinil for PAH (from a cohort of 51 patients [27%]), who wished to discontinue treatment because of injection-site pain. The etiology of their PAH included iPAH (7 of 14), PAH secondary to scleroderma (2 of 14), thromboembolic disease (3 of 14) and PAH post-surgical correction of ventricular septal defect (2 of 14). Treprostinil was gradually weaned and all patients were started open-label with 50 mg sildenafil four times per day for 3 months. New York Heart Association (NYHA) functional class, SMWD, echocardiogram and quality-of-life (QOL) measures were determined at baseline and after 3 months of therapy with sildenafil. RESULTS: Of 14 patients, 4 discontinued the transition because of deterioration during treprostinil withdrawal, despite the introduction of sildenafil. Replacement of chronic subcutaneous treprostinil with sildenafil was possible in 10 of 14 patients (71%), who demonstrated stable NYHA class (mean +/- SD: 3.1 +/- 0.3 at baseline to 2.6 +/- 0.8 at 3 months, p = 0.138), stable SMWD (434 +/- 83 m at baseline, 451 +/- 72 at 3 months, p = 0.23) and significantly improved QOL measures at 3 months. CONCLUSIONS:
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Authors | Anne M Keogh, Andrew Jabbour, Robert Weintraub, Karen Brown, Chris S Hayward, Peter S Macdonald |
Journal | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
(J Heart Lung Transplant)
Vol. 26
Issue 11
Pg. 1079-83
(Nov 2007)
ISSN: 1557-3117 [Electronic] United States |
PMID | 18022071
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Antihypertensive Agents
- Piperazines
- Purines
- Sulfones
- Vasodilator Agents
- Sildenafil Citrate
- Epoprostenol
- treprostinil
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Topics |
- Administration, Oral
- Adult
- Antihypertensive Agents
(administration & dosage, adverse effects, therapeutic use)
- Drug-Related Side Effects and Adverse Reactions
- Epoprostenol
(administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
- Exercise Tolerance
- Female
- Humans
- Hypertension, Pulmonary
(drug therapy, etiology, physiopathology)
- Injections, Subcutaneous
- Male
- Middle Aged
- Piperazines
(administration & dosage, adverse effects, therapeutic use)
- Purines
(administration & dosage, adverse effects, therapeutic use)
- Quality of Life
- Sildenafil Citrate
- Sulfones
(administration & dosage, adverse effects, therapeutic use)
- Vasodilator Agents
(administration & dosage, adverse effects, therapeutic use)
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