[Role of prostacyclin and its derivatives in the treatment of pulmonary arterial hypertension].
Pulmonary arterial hypertension (PAH) is defined as a group of diseases characterised by a progressive increase of pulmonary vascular resistance leading to right ventricular failure and death. A dysregulation of prostacyclin metabolic pathways has been demonstrated in patients with PAH and in experimental models. Recently, therapy with continuous intravenous prostacyclin (epoprostenol) has been shown to improve symptoms and prognosis in New York Heart Association (NYHA) functional class III and IV patients with different types of PAH. However, epoprostenol administration requires invasive methods with a permanent intravenous catheter and is associated with several side effects and potentially serious complications. Other modes of prostacyclin therapies are being considered using stable prostacyclin analogues administered by inhalation (iloprost), subcutaneously (treprostinil) or orally (beraprost). Over the last years, different multicenter international double-blind trials have demonstrated the efficacy of those novel prostacyclin analogues in PAH compared to conventional therapy promising a better future for these patients.
Osvaldo Cáneva
Jorge
J
Sección Neumonología, Fundación Favaloro, Av Belgrano 1746, 1093 Buenos Aires, Argentina. jcaneva@ffavaloro.org
Ossés
Juan Manuel
JM
D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D011464:Epoprostenol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D016285:Iloprost / Q000008:administration & dosage; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D000959:Antihypertensive Agents; D014665:Vasodilator Agents; C048081:beraprost; D011464:Epoprostenol; D016285:Iloprost; C427248:treprostinil