Efficacy and safety of treprostinil: An epoprostenol analog for primary pulmonary hypertension

Vallerie V. McLaughlin*, Sean P. Gaine, Robyn J. Barst, Ronald J. Oudiz, Robert C. Bourge, Adaani Frost, Ivan M. Robbins, Victor F. Tapson, Michael D. McGoon, David B. Badesch, Jeff Sigman, Robert Roscigno, Shelmer D. Blackburn, Carl Arneson, Lewis J. Rubin, Stuart Rich

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

189 Scopus citations

Abstract

Intravenous epoprostenol is currently FDA approved for management of primary pulmonary hypertension, but it requires intravenous infusion and is associated with adverse effects. The objective of this study was to evaluate the effects of an epoprostenol analog, treprostinil, for management of pulmonary hypertension. Ten tertiary care academic institutions with pulmonary hypertension programs participated in these pilot trials. In the first trial, intravenous epoprostenol and intravenous treprostinil were compared. In the second trial, intravenous treprostinil and subcutaneous treprostinil were compared. In the third trial, subcutaneous treprostinil was compared with placebo infusion during an 8-week period. Intravenous epoprostenol and intravenous treprostinil resulted in a similar reduction in pulmonary vascular resistance acutely (22% and 20%, respectively). Intravenous treprostinil and subcutaneous treprostinil also demonstrated comparable short-term decrease in pulmonary vascular resistance (23% and 28%, respectively). The placebo-controlled 8-week trial demonstrated a mean improvement of 37 ± 17 m as measured by the 6-minute walk distance in patients receiving treprostinil compared with a 6 ± 28 m reduction in those receiving placebo. There were trends toward an improvement in cardiac index and pulmonary vascular resistance index in the treprostinil group. Subcutaneous treprostinil has favorable hemodynamic effects when given acutely and in the short term. Treprostinil can be given safely to an ambulatory patient with a novel subcutaneous delivery pump system.

Original languageEnglish (US)
Pages (from-to)293-299
Number of pages7
JournalJournal of Cardiovascular Pharmacology
Volume41
Issue number2
DOIs
StatePublished - Feb 1 2003

Keywords

  • Epoprostenol
  • Hemodynamics
  • Prostacyclin
  • Pulmonary arterial hypertension

ASJC Scopus subject areas

  • Pharmacology
  • Cardiology and Cardiovascular Medicine

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