Abstract:
BACKGROUND:Infused and inhaled treprostinil are effective for treatment of pulmonary arterial hypertension (PAH), although their administration routes have limitations. This study assessed the efficacy and safety of bid oral sustained-release treprostinil in the treatment of PAH with a concomitant endothelin receptor antagonist (ERA) and/or phosphodiesterase type 5 inhibitor. METHODS:A 16-week, multicenter, double-blind, placebo-controlled study was conducted in 350 patients with PAH randomized to placebo or oral treprostinil. All patients were stable on background ERA, PDE-5 inhibitor, or both. Primary end point was Hodges-Lehmann placebo-corrected median difference in change from baseline 6-min walk distance (6MWD) at week 16. Secondary end points included time to clinical worsening, change in World Health Organization functional class, Borg dyspnea score, and dyspnea fatigue index score. RESULTS:Thirty-nine patients (22%) receiving oral treprostinil and 24 patients (14%) receiving placebo discontinued the study. Placebo-corrected median difference in change from baseline 6MWD at week 16 was 11 m (P = .07). Improvements in dyspnea fatigue index score (P = .01) and combined 6MWD and Borg dyspnea score (P = .01) were observed with oral treprostinil vs placebo treatment. Patients who achieved a week-16 bid oral treprostinil dose of 1.25 to 3.25 mg and 3.5 to 16 mg experienced a greater change in 6MWD (18 m and 34 m, respectively) than patients who achieved a bid dose of < 1 mg or discontinued because of adverse events (4 m). CONCLUSIONS:The primary end point of improvement in 6MWD at week 16 did not achieve significance. This study enhanced understanding of oral treprostinil titration and dosing, which has set the stage for additional studies. TRIAL REGISTRY:ClinicalTrials.gov; No.: NCT00325442; URL: www.clinicaltrials.gov.
journal_name
Chestjournal_title
Chestauthors
Tapson VF,Torres F,Kermeen F,Keogh AM,Allen RP,Frantz RP,Badesch DB,Frost AE,Shapiro SM,Laliberte K,Sigman J,Arneson C,Galiè Ndoi
10.1378/chest.11-2212subject
Has Abstractpub_date
2012-12-01 00:00:00pages
1383-1390issue
6eissn
0012-3692issn
1931-3543pii
S0012-3692(12)60668-0journal_volume
142pub_type
杂志文章,多中心研究,随机对照试验相关文献
CHEST文献大全abstract::Closure of ventricular septal defects through the aortic valve annulus has been described for a variety of cardiac anomalies. This technique is most appropriate when simultaneous aortic valve replacement is anticipated. A continuous suture through the patch material may produce a purse-string effect upon the aortic va...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.70.2.311
更新日期:1976-08-01 00:00:00
abstract:STUDY OBJECTIVES:To define the clinical characteristics of the patients showing bronchoscopic findings of bronchial narrowing or obliteration with black pigmentation on overlying mucosa (we named this finding as "anthracofibrosis"), and to determine the association of anthracofibrosis with tuberculosis. PATIENTS AND M...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.113.2.344
更新日期:1998-02-01 00:00:00
abstract::In patients with acquired or congenital heart diseases, the systolic pulmonary artery pressure (PAPs) can be predicted using continuous-wave Doppler ultrasound (CWD) measurement of the peak velocity of a tricuspid regurgitation (TR) jet. The aim of this study was to determine whether CWD could be used to accurately es...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.96.6.1258
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:We recently showed that administration of the combination of the noradrenergic drug atomoxetine plus the antimuscarinic oxybutynin (ato-oxy) prior to sleep greatly reduced OSA severity, likely by increasing upper airway dilator muscle activity during sleep. In patients with OSA who performed the ato-oxy tria...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2020.01.012
更新日期:2020-06-01 00:00:00
abstract::The adverse effects of prolonged immobility are due primarily to gravitational effects on blood flow and ventilation, impairment of the normal mucociliary escalator and possibly an increase in extravascular lung water. However, CLRT theoretically should reverse these abnormalities. The sequence of events that culminat...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验,评审
doi:10.1378/chest.99.5.1263
更新日期:1991-05-01 00:00:00
abstract::The spontaneous variability of arterial blood gas and pH values (ABGs) was examined in a group of 28 typical stable medical ICU patients under a variety of ventilatory conditions. In each patient, 13 ABG specimens were measured at 5-min intervals during a 1-h study period using a new bedside, extravascular fluorescent...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.106.1.187
更新日期:1994-07-01 00:00:00
abstract:STUDY OBJECTIVE:Factors influencing diastolic filling of the left ventricle may serve as critical determinants of both maximal cardiac output and oxygen uptake. This study was conducted to assess diastolic filling dynamics of the left ventricle during progressive upright cycle exercise in children. METHODS:Twelve boys...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.120.1.145
更新日期:2001-07-01 00:00:00
abstract::We report a case of Behçet's disease with pulmonary and splenic involvement. The radiologic presentation was quite different from the modes defined in the literature. A large, anteriorly located, well circumscribed ovoid mass was the x-ray film image of a large area of infarction with hemorrhage. The involved pulmonar...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.104.5.1635
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:The use of infrared thermometry to measure temperatures in hospitalized patients is increasing. Although infrared thermometers have been proven to be accurate when they are used by well-trained personnel, no previous studies have examined their accuracy during routine hospital use. OBJECTIVE:To determine th...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.115.4.1002
更新日期:1999-04-01 00:00:00
abstract::A smoker presented with pleuritic chest pain and was found to have reticulonodular interstitial opacities on chest x-ray film. Open lung biopsy revealed changes consistent with histiocytosis X, a disease seen almost exclusively in smokers. Smoking cessation was recommended, and the patient complied. A chest x-ray film...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.98.3.765
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVE:To assess the effect of baseline variables, including treatment, on outcome in patients with nosocomial pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA). DESIGN:Retrospective analysis of data from two prospective, randomized, double-blind studies. SETTING:Multinational study with 134 site...
journal_title:Chest
pub_type: 杂志文章
doi:
更新日期:2003-11-01 00:00:00
abstract::The clinical course of congestive heart failure (CHF) and mitral valve stenosis (MVS) is accompanied by episodes of dyspnea, wheezing, and cough, symptoms also observed in patients with bronchial hyperreactivity. However, it is still controversial whether bronchial hyperreactivity is demonstrable in patients with chro...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.5.1477
更新日期:1993-05-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate an equation that estimates resting energy expenditure from two easily obtained measurements--expired carbon dioxide and minute ventilation, and compare the results of this equation with standard methods of estimating and measuring caloric expenditure in mechanically ventilated patients. DES...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.105.2.544
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:Carotid arteriosclerosis and sleep apnea are considered as independent risk factors for stroke. Whether sleep apnea mediates severity of carotid stenosis remains unclear. Sleep apnea comprises two pathophysiologic conditions: OSA and central sleep apnea (CSA). Although OSA results from upper airway occlusion...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.14-1655
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:The majority of community-acquired pneumonia (CAP) patients (about 80%) will be treated as outpatients, because therapy with a single agent will work. For the remaining 20% of patients requiring hospitalization, there is some growing debate regarding the efficacy of different management approaches. For hospi...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.128.2.940
更新日期:2005-08-01 00:00:00
abstract::A critically-ill 73-year-old man was admitted with simultaneous mitral valve endocarditis and aortic stenosis. Balloon aortic valvuloplasty was performed successfully and without complications and was followed by prompt clinical improvement. Balloon aortic valvuloplasty should be considered in patients with aortic ste...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.99.6.1534
更新日期:1991-06-01 00:00:00
abstract::A radioaerosol procedure using 99mcTc-DTPA (diethylene triamine penta acetate) was used to evaluate the permeability of the pulmonary epithelium in smokers and nonsmokers. The average clearance of this indicator from the lungs of smokers without significant airway obstruction exceeded that found in normal subjects by ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.83.1.6
更新日期:1983-01-01 00:00:00
abstract::Because PGE1 previously has been reported to increase survival of patients with ARDS, we evaluated physiologic effects and side effects of PGE1 in a prospective open-label study of patients with ARDS. Seventeen patients with ARDS who did not have significant renal or hepatic dysfunction received PGE1 by continuous cen...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.97.3.684
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:There is no consensus at the present time about the effect of welding on lung function decline. This study compared lung function decline between blue-collar workers exposed and not exposed to welding fumes in a French longitudinal cohort of 21,238 subjects aged 37 to 52 years at inclusion. METHODS:Medical ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.11-0647
更新日期:2012-07-01 00:00:00
abstract:STUDY OBJECTIVES:Pulmonary fibrosis due to lipid peroxidation is a major symptom of paraquat intoxication. Ethane in the expired breath (exEth) reflects lipid peroxidation and may be a measure of the damage effected by oxygen radicals in acute lung injury. The purpose of this study was to evaluate the clinical efficacy...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.128.3.1506
更新日期:2005-09-01 00:00:00
abstract::We studied eleven patients during 14 attempts at weaning from mechanical ventilation to determine whether central ventilatory drive, measured as airway occlusion pressure 0.1 s after onset of inspiration (P 0.1), during spontaneous breathing before and during a brief hypercapnic challenge, could accurately predict the...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.91.4.496
更新日期:1987-04-01 00:00:00
abstract:BACKGROUND:It has been postulated that differences in provocative concentration of methacholine causing a 20% fall in FEV1 (PC20) values between the dosimeter method and tidal breathing method might be due to differences in the dose of agonist delivered to the mouth. The aim of the present study was to determine the in...
journal_title:Chest
pub_type: 杂志文章,随机对照试验
doi:10.1378/chest.08-0093
更新日期:2008-10-01 00:00:00
abstract::The goal of this article is to provide an update on recent changes to current procedural terminology codes used for billing physician services for mechanical ventilation in chronic care facilities. In addition to billing information, background data relevant to prolonged mechanical ventilation are reviewed. Topics cov...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.07-0656
更新日期:2008-02-01 00:00:00
abstract::Previous studies have described oxygen delivery (DO2) and oxygen consumption (VO2) relationships in patients with ARDS and other acute diseases that suggest occasions when VO2 may be dependent on the supply of oxygen, ie, DO2. We studied 127 postoperative patients who developed ARDS to evaluate the relationship of DO2...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.102.3.906
更新日期:1992-09-01 00:00:00
abstract:STUDY OBJECTIVES:Community-acquired pneumonia (CAP) is a widespread disease with important implications for health-care systems worldwide. This study investigated direct costs, treatment patterns, and outcomes associated with two patient cohorts hospitalized with CAP. DESIGN:The study design was naturalistic, prospect...
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:10.1378/chest.128.4.2238
更新日期:2005-10-01 00:00:00
abstract::Between January 1990 and August 1991, there were 37 patients admitted to our Department of Internal Medicine with hematologic malignancies or solid tumors who showed colonization of the respiratory tract with Pseudomonas cepacia. Extensive surveillance cultures of the environmental surfaces and respiratory equipment o...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.6.1706
更新日期:1993-06-01 00:00:00
abstract::Radiation therapy has been the usual initial treatment for mediastinal seminoma in the past. However, 25 to 40 percent of patients are not cured by this therapy, and other therapy is needed. Review of case reports show that vinblastine, bleomycin, and cis-platinum are effective therapy for metastatic disease, advanced...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.83.2.263
更新日期:1983-02-01 00:00:00
abstract:STUDY OBJECTIVES:To evaluate the intraoperative evolution of patients with COPD during lung resection and to test whether exercise testing could be helpful in the prediction of the intraoperative course. DESIGN:Prospective study. SETTING:University teaching hospital. PATIENTS:Forty patients (mean [+/- SD] age, 65 +/...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.120.3.852
更新日期:2001-09-01 00:00:00
abstract::This prospective study compared two weaning modalities in COPD patients requiring mechanical ventilation (MV) for acute respiratory failure. Nineteen patients with COPD were studied when their precipitating illness was controlled. Although they satisfied the conventional bedside weaning criteria, they could not tolera...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.105.4.1204
更新日期:1994-04-01 00:00:00
abstract::A diagnosis of severe obstructive sleep apnea was made after a 52-year-old hypertensive man developed a large intracranial hemorrhage. Therapeutic noninvasive positive pressure ventilation (NPPV) for obstructive sleep apnea and hypoventilation was complicated by transient unilateral orbital herniation. As best as can ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.113.3.841
更新日期:1998-03-01 00:00:00