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Clinical use of extended-release oral treprostinil in the treatment of pulmonary arterial hypertension

Authors Pugliese S, Bull T

Received 6 July 2015

Accepted for publication 15 October 2015

Published 25 January 2016 Volume 2016:9 Pages 1—7

DOI https://doi.org/10.2147/IBPC.S68230

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Panagiotis Xaplanteris

Peer reviewer comments 3

Editor who approved publication: Dr Steven Atlas


Steven C Pugliese,1 Todd M Bull1,2

1Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, 2UCD Pulmonary Vascular Disease Center, Division of Pulmonary Sciences and Critical Care Medicine and Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA


Abstract: The development of parenteral prostacyclin therapy marked a dramatic breakthrough in the treatment of pulmonary arterial hypertension (PAH). Intravenous (IV) epoprostenol was the first PAH specific therapy and to date, remains the only treatment to demonstrate a mortality benefit. Because of the inherent complexities and risks of treating patients with continuous infusion IV therapy, there is great interest in the development of an oral prostacyclin analog that could mimic the benefits of IV therapy. Herein, we highlight the development of oral prostacyclin therapy, focusing on oral treprostinil, the only US Food and Drug Administration approved oral prostacyclin. Recent Phase III clinical trials have shown the drug to improve exercise tolerance in treatment-naïve PAH patients, but not patients on background oral therapy. Oral treprostinil appears to be most efficacious at higher doses, but its side effect profile and complexities with dosing complicate its use. While oral treprostinil’s current therapeutic role in PAH remains unclear, ongoing studies of this class of medication should help clarify their role in the treatment of PAH.

Keywords: oral treprostinil, pulmonary arterial hypertension, selexipag

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