title: Impact of switching from epoprostenol to IV treprostinil on treatment satisfaction and quality of life in patients with pulmonary hypertension.
abstract: BACKGROUND
  Transition from intravenous (IV) epoprostenol to IV treprostinil in patients with pulmonary hypertension (PH) has traditionally been performed by gradually decreasing the epoprostenol dose while increasing the treprostinil dose. Preliminary data suggest that this transition can be performed more rapidly without the need for epoprostenol weaning. We conducted a single center, prospective clinical trial to assess the safety, efficacy, and treatment satisfaction of rapidly switching from epoprostenol to IV treprostinil.
  
  
  METHODS
  This study included patients with PH who had rapidly transitioned from epoprostenol to IV treprostinil. Data collected included clinical status, adverse events, PH symptoms, and previously validated measures of quality of life and treatment satisfaction.
  
  
  RESULTS
  Ten patients were enrolled in this study. Exercise capacity measured by mean 6-min walk distance was maintained from baseline throughout follow-up. Severity of disease as assessed by WHO functional class was maintained or improved for the majority of patients. Adverse events were minimal during the transition, and all patients remained on IV treprostinil throughout the follow-up period. A favorable impact on quality of life and treatment satisfaction measures was observed by eight weeks following the transition from epoprostenol to IV treprostinil. Specifically, time spent on drug preparation activities decreased by 39.5% with treprostinil compared to epoprostenol.
  
  
  CONCLUSIONS
  Rapidly switching from epoprostenol to IV treprostinil can be achieved without safety concerns, with minimal patient monitoring and without the need for extended hospitalization, while favorably impacting on patients' quality of life.
authors.affiliation: Department of Pulmonary, Allergy and Critical Care Medicine, Cleveland Clinic, Cleveland, OH 44195, USA. minaio@ccf.org
authors.forename: O A
authors.initials: OA
authors.lastname: Minai
authors.forename: J
authors.initials: J
authors.lastname: Parambil
authors.forename: R A
authors.initials: RA
authors.lastname: Dweik
authors.forename: G H
authors.initials: GH
authors.lastname: Davila
authors.forename: L
authors.initials: L
authors.lastname: Peterson
authors.forename: K D
authors.initials: KD
authors.lastname: Rollins
authors.forename: H
authors.initials: H
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D057915:Drug Substitution / Q000379:methods / Q000523:psychology; D011464:Epoprostenol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents; D011464:Epoprostenol; C427248:treprostinil