title: Combination therapy in pulmonary arterial hypertension.
abstract: Despite major advances in understanding the mechanisms of disease and development of specific drug therapy, pulmonary arterial hypertension (PAH) remains a progressive, fatal disease. At present there are 3 classes of drug therapy for PAH: prostaglandins, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors. To maximize therapeutic benefit, and according to national and international guidelines, many patients are treated with combinations of these medications. This review presents a detailed account of the published data on the use of combination therapy in PAH. There are few randomized, placebo-controlled trial data to strongly support efficacy of most combination therapy, particularly oral combination therapy.
authors.affiliation: Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University, T1218 Medical Center North, 1161 21st Avenue South, Nashville, TN 37232, USA.
authors.forename: Meredith E
authors.initials: ME
authors.lastname: Pugh
authors.forename: Anna R
authors.initials: AR
authors.lastname: Hemnes
authors.forename: Ivan M
authors.initials: IM
authors.lastname: Robbins
mesh_terms: D004359:Drug Therapy, Combination; D065128:Endothelin Receptor Antagonists; D011464:Epoprostenol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D065627:Familial Primary Pulmonary Hypertension; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use*; D011453:Prostaglandins / Q000627:therapeutic use
chemical_list: D065128:Endothelin Receptor Antagonists; D058986:Phosphodiesterase 5 Inhibitors; D011453:Prostaglandins; D011464:Epoprostenol
keywords: Combination therapy; Endothelin receptor antagonists; Phosphodiesterase-5 inhibitors; Prostacyclin; Pulmonary arterial hypertension; Treatment