Gaps in evidence in the treatment of prevalent patients with pulmonary arterial hypertension at intermediate risk: An expert consensus

被引：2

作者：

Manzi, Giovanna ^{[1
]}

Benza, Raymond L. ^{[2
]}

Argiento, Paola ^{[3
]}

Casu, Gavino ^{[4
]}

Corda, Marco ^{[5
]}

Correale, Michele ^{[3
,6
]}

D'Alto, Michele

Galgano, Giuseppe ^{[7
]}

Garascia, Andrea ^{[8
]}

Ghio, Stefano ^{[9
]}

Gomberg-Maitland, Mardi ^{[10
]}

Mule, Massimiliano ^{[11
]}

Paciocco, Giuseppe ^{[12
]}

Papa, Silvia

Prati, Daniele ^{[13
]}

Preston, Ioana R. ^{[14
]}

Raineri, Claudia ^{[15
]}

Romeo, Emanuele

Scelsi, Laura

Stolfo, Davide ^{[16
,17
]}

Vitulo, Patrizio ^{[18
]}

White, R. James ^{[19
]}

Badagliacca, Roberto ^{[1
]}

Vizza, Carmine Dario ^{[1
]}

机构：

[1] Sapienza Univ Rome, Policlin Univ Umberto I, Dept Clin Internal Anesthesiol & Cardiovasc Sci, I-00161 Rome, Italy

[2] Mt Sinai Icahn Sch Med, Dept Cardiol, New York, NY USA

[3] Monaldi Hosp Univ L Vanvitelli, Dept Cardiol, Naples, Italy

[4] Sassari Univ Hosp, Clin & Intervent Cardiol, Sassari, Italy

[5] ARNAS G Brotzu, Cardiovasc Dept, Cardiol Unit, Cagliari, Italy

[6] Policlin Riuniti Univ Hosp, Cardiothorac Dept, Foggia, Italy

[7] F Miulli Hosp, Dept Cardiol, Bari, Italy

[8] Osped Niguarda Ca Granda, De Gasperis Cardio Ctr, I-20162 Milan, Italy

[9] Fdn IRCCS Policlin S Matteo, Pavia, Italy

[10] George Washington Univ, Sch Med & Hlth Sci, Washington, DC USA

[11] Univ Catania, Reg Referral Ctr Rare Lung Dis, Dept Clin & Expt Med, AOU Policlin San Marco, Catania, Italy

[12] Univ Milano Bicocca, Cardiovasc & Thorac Dept, Pneumol Unit, IRCCS San Gerardo Tintori, Monza, Italy

[13] Univ Verona, Dept Clin & Expt Med, Sect Internal Med, I-37134 Verona, Italy

[14] Tufts Univ, Sch Med, Boston, MA USA

[15] Citta Salute & Sci Osped Molinette, Dept Cardiol, Turin, Italy

[16] Azienda Sanit Univ Giuliano Isontina ASUGI, Univ Hosp Trieste, Cardiothoracovasc Dept, Trieste, Italy

[17] Karolinska Inst, Dept Mediupcocine, Div Cardiol, Stockholm, Sweden

[18] IRCCS Mediterranean Inst Transplantat & Adv Specia, Dept Pulm Med, Therapies Palermo Sicilia, Palermo, Italy

[19] Univ Rochester, Dept Pulm & Crit Care Med, Rochester, NY USA

来源：

VASCULAR PHARMACOLOGY | 2024年 / 157卷

关键词：

Pulmonary arterial hypertension; Intermediate risk; PAH therapeutic options; Expert consensus; ENDOTHELIN RECEPTOR ANTAGONIST; 5 INHIBITOR THERAPY; COMBINATION THERAPY; INHALED TREPROSTINIL; ORAL TREPROSTINIL; CLINICAL-EFFICACY; YOUNG-ADULTS; SILDENAFIL; BOSENTAN; TADALAFIL;

D O I：

10.1016/j.vph.2024.107432

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Despite the innovations introduced in the 2022 European Society of Cardiology/European Respiratory Society Guidelines on Pulmonary Hypertension, risk discrimination and management of pulmonary arterial hypertension (PAH) patients at intermediate risk still represents a grey zone. Additionally, clinical evidence derived from currently available studies is limited. This expert panel survey intends to aid physicians in choosing the best therapeutic strategy for patients at intermediate risk despite ongoing oral therapy. An expert panel of 24 physicians, specialized in cardiology and/or pulmonology with expertise in handling all drugs available for the treatment of PAH participated in the survey. All potential therapeutic options for patients at intermediate risk were explored and analyzed to produce graded consensus statements regarding: the switch from endothelin receptor antagonist (ERA) or phosphodiesterase 5 inhibitor (PDE5i) to another oral drug of the same class; the addition of a drug targeting the prostacyclin pathway administered by different routes; the switch from PDE5i to riociguat.

引用

页数：9

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