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2015 ; 6
(5
): 264-72
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Medical treatment update on pulmonary arterial hypertension
#MMPMID26336595
Enderby CY
; Burger C
Ther Adv Chronic Dis
2015[Sep]; 6
(5
): 264-72
PMID26336595
show ga
Pulmonary arterial hypertension is a chronic, progressive disease of the
pulmonary vasculature resulting in poor outcomes if left untreated. The
management of group 1 pulmonary arterial hypertension has included the use of
prostanoids, phosphodiesterase-5 inhibitors, and endothelin receptor antagonists
targeting the prostacyclin, endothelin-1, and nitric oxide pathways. Three new
medications have been approved by the US Food and Drug Administration over the
past couple of years. Macitentan is the newest endothelin receptor antagonist,
riociguat is a soluble guanylate cyclase stimulator, and treprostinil diolamine
is the first oral prostanoid. This review will focus on the key trials leading to
their approval, special considerations for each medication, and their potential
place in therapy. The use of combination therapy as initial therapy in pulmonary
arterial hypertension will also be discussed.