A new class of drug for pulmonary arterial hypertension. Can a Rho-kinase inhibitor break the stagnation in treating it?
A new class of drug for pulmonary arterial hypertension. Can a Rho-kinase inhibitor break the stagnation in treating it?
复制标题
一类新的肺动脉高压药物。
DOI：
10.1253/circj.cj-13-0951
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
N. Emoto
中科院分区：
文献类型：
--
作者：
K. Miyagawa;N. Emoto
目前已确定的治疗靶点有3个：内皮素途径、一氧化氮(NO)-环鸟苷单磷酸（cGMP）途径和前列环素途径1针对各自的途径，内皮素受体拮抗剂（ERAs）、磷酸二酯酶-5 （PDE5）抑制剂和前列环素类似物目前可用。此外，针对每一种途径正在开发新的药物类别。Macitentan是一种对内皮素受体具有高亲和力并对内皮素系统具有强抑制作用的新型ERA，可能在不久的将来成为一线药物。肺动脉高压（PAH）是一种进行性难治性疾病，以肺血管阻力升高、右心衰为特征，在没有治疗或肺移植的情况下最终导致死亡。有针对性的药物治疗已经建立，并且最近在PAH治疗方面的进展已经导致PAH患者的症状、运动能力和预后的改善；然而，药物治疗的效果并不完全令人满意，REVEAL注册显示，特发性多环芳烃患者的5年生存率为64.5%。新药的开发有望打破目前多环芳烃治疗方案的停滞不前。P
At present, there are 3 established therapeutic targets: the endothelin pathway, the nitric oxide (NO)-cyclic guanosine mono-phosphate (cGMP) pathway, and the prostacyclin pathway.1 To target the respective pathways, endothelin-receptor antagonists (ERAs), phosphodiesterase-5 (PDE5) inhibitors, and prostacyclin analogs are currently available. Moreover, new classes of drugs are being developed for each of these pathways. Macitentan, a new ERA that has a high affinity for endothelin receptors and causes robust inhibition of the endothelin system,3 may be a first-line drug in the near future. A direct guanylate cyclase stimulator, riociguat, and selexipag, ulmonary arterial hypertension (PAH) is a progressive intractable disease that is characterized by elevated pulmonary vascular resistance, right heart failure, and ultimately death, in the absence of treatment or lung transplantation. Targeted medical therapy has been established,1 and recent advances in the management of PAH have led to improvement in symptoms, exercise capacity, and prognosis for patients with PAH; however, the efficacy of medical therapy is not entirely satisfactory, as shown in the REVEAL registry, which documents a 5-year survival rate of 64.5% for patients with idiopathic PAH.2 The development of new drugs is expected to break the current stagnation in PAH treatment options. P
影响因子：
1.7
作者：
Surma M;Wei L;Shi J
通讯作者：
Shi J
影响因子：
15.9
作者：
Rabinovitch, Marlene
通讯作者：
Rabinovitch, Marlene