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Experience in Transitioning from Parenteral Prostacyclins to Selexipag in Pulmonary Arterial Hypertension.

07:00 EST 13th January 2020 | BioPortfolio

Summary of "Experience in Transitioning from Parenteral Prostacyclins to Selexipag in Pulmonary Arterial Hypertension."

Parenteral prostacyclin therapies remain first line therapy for patients with pulmonary arterial hypertension (PAH) with class IV symptoms. In selected patients who have been clinically stabilized, switching to selexipag, a chemically distinct prostacyclin receptor agonist, may alleviate risks associated with long-term parenteral therapy. We report our experience with transition of patients from parenteral prostacyclin therapy to selexipag. From January 2016 to July 2017 patients with PAH at Duke University Pulmonary Vascular Disease Center with functional class II symptoms on stable parenteral prostacyclin therapy were offered the opportunity to transition to selexipag. A standardized protocol was developed to guide titration of therapies. Patients underwent pre- and post-transition assessments of hemodynamics, echocardiography, laboratory biomarkers, and functional status. We studied 14 patients with PAH (11 women; median age 53 years) in total. Overall, 13 patients tolerated the switch to selexipag and remained on the drug at study completion and 1 patient passed away due to progressive liver failure. Surrogate markers including NT-proBNP, 6MWD, RV function, TAPSE, and right heart catheterization hemodynamics were similar pre- and post-transition. The transition from parenteral prostanoid therapy to oral selexipag was overall well-tolerated in patients with stable PAH and functional class II symptoms. Finally, doses of selexipag up to 3200 mcg twice daily were well-tolerated in patients who had been treated with prior parenteral prostacyclins.

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This article was published in the following journal.

Name: Journal of cardiovascular pharmacology
ISSN: 1533-4023
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