[Combination therapy].
The goal of combination therapy in patients with pulmonary arterial hypertension (PAH) is aimed at maximizing therapeutic efficacy while limiting toxicity and drug interactions. Because PAH is a rare disease, it is difficult to adequately power therapeutic trials to evaluate significant morbidity or mortality differences between various drug therapies. At this point, it is premature to either dismiss or strongly favor any one combination of therapies over another. There is debate among PAH specialists as to whether combination therapy should be reserved for patients whose condition deteriorates (add on therapy) or should be started up front and followed by maintenance therapy with one or more agents once patients have improved. Careful design of future trials testing these comparisons is very important.
Okano
Yoshiaki
Y
Clinical Laboratory Medicine, Graduate School of Medicine, Kyoto University.
D004359:Drug Therapy, Combination; D065128:Endothelin Receptor Antagonists; D011464:Epoprostenol / Q000008:administration & dosage; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D058986:Phosphodiesterase 5 Inhibitors
D065128:Endothelin Receptor Antagonists; D058986:Phosphodiesterase 5 Inhibitors; D011464:Epoprostenol