Abstract:
:Oral treprostinil (TRE) is a prostacylin that is approved for the treatment of patients with pulmonary arterial hypertension (PAH). Dosing is approved for two or three times daily (t.i.d.); however, adverse effects, including gastrointestinal-related symptoms, may limit the ability to reach optimal doses. We report our experience with a four times daily (q.i.d.) regimen of oral TRE for goal-directed therapy of PAH. We describe three patients that were transitioned from infusion or inhaled TRE to oral TRE with initial t.i.d. dosing over a four-day hospital stay. All patients were subsequently further dose-adjusted in the outpatient setting; however, adverse effects limited additional up-titration despite persistent dyspnea. In a carefully monitored outpatient setting, patients were switched from t.i.d. to q.i.d. dosing of oral TRE. All three patients were successfully dosed q.i.d., having achieved a higher total daily dose compared with a t.i.d. dose regimen. Furthermore, patients were able to maintain functional class II symptoms with mitigation of adverse effects using the q.i.d. dose regimen.
journal_name
Pulm Circjournal_title
Pulmonary circulationauthors
Coons JC,Bunner C,Ishizawar DC,Risbano MG,Rivera-Lebron B,Mathier MA,Chan SY,Simon MAdoi
10.1177/2045893217744512subject
Has Abstractpub_date
2018-01-01 00:00:00pages
2045893217744512issue
1eissn
2045-8932issn
2045-8940journal_volume
8pub_type
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