Experiences with treprostinil in the treatment of pulmonary arterial hypertension.
Experiences with treprostinil in the treatment of pulmonary arterial hypertension.
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DOI：
10.1177/1753465812455368
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发表时间：
2012-10
影响因子：
4.3
通讯作者：
Bull TM
中科院分区：
文献类型：
--
作者：
Stream AR;Bull TM
肺动脉高压（PAH）是一种肺动脉压力升高伴肺血管阻力增加的慢性疾病，可导致右心室衰竭，在引入肺动脉高压特异性治疗之前，右心室衰竭几乎都是致命的。全身性前列环素类似物是第一种可用的PAH特异性治疗，通常推荐作为重度疾病受试者的一线治疗。曲前列尼尔是一种较新的前列环素类似物，其作用机制和相对疗效与依前列醇相似，其优点是在人血清中的半衰期较长，室温稳定性较好。它的独特之处在于它有多种剂型可供选择，包括皮下、静脉和吸入途径。此外，口服曲前列尼尔目前正在研究中。曲前列环素的皮下注射和静脉注射形式均已在短期临床试验中证明了疗效，目前在美国获批用于PAH和纽约心脏协会心功能分级（NYHA FC）II-IV症状受试者，在欧洲获批用于NYHA FC III和IV症状受试者。在短期临床试验中，吸入型曲前列尼尔也显示出疗效，主要作为辅助治疗，目前在美国和欧洲获批用于PAH和NYHA FC III-IV症状的受试者。曲前列环素的不同制剂显著增加了PAH患者的治疗选择和治疗机会。
Pulmonary arterial hypertension (PAH) is a chronic condition of elevated pulmonary arterial pressures with associated increases in pulmonary vascular resistance leading to right ventricular failure, which was almost uniformly fatal prior to the introduction of pulmonary hypertension specific therapy. Systemic prostacyclin analogs are the first PAH-specific therapies to be made available and are typically recommended as first-line therapy for subjects with severe disease. Treprostinil is a newer prostacyclin analog similar to epoprostenol in its mechanism of action and relative efficacy with the advantage of a longer half life in human serum and room temperature stability. It is unique in that it is available in multiple formulations for alternative routes of delivery, including subcutaneous, intravenous and inhalational routes. Additionally, oral treprostinil is currently under investigation. Both subcutaneous and intravenous forms of treprostinil have demonstrated efficacy in short-term clinical trials and are currently approved for use in subjects with PAH and New York Heart Association functional class (NYHA FC) II–IV symptoms in the USA and for subjects with NYHA FC III and IV in Europe. Inhaled treprostinil has also demonstrated efficacy in short-term clinical trials primarily as add-on therapy and is currently approved for use in subjects with PAH and NYHA FC III–IV symptoms in the USA and Europe. The different formulations of treprostinil have significantly increased the treatment options and opportunities for treatment of patients with PAH.
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影响因子：
24.3
作者：
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通讯作者：
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158.5
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通讯作者：
Galie, Nazzareno
影响因子：
158.5
作者：
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通讯作者：
Crow, JW