State of artSubcutaneous treprostinil in pulmonary arterial hypertension: Practical considerations
Section snippets
Clinical profile of SC treprostinil
Subcutaneously administered treprostinil is rapidly and completely absorbed, with 100% bioavailability.18 The pharmacokinetics of SC treprostinil (steady state) were demonstrated to be dose proportional over a range of 2.5 to 15 ng/kg/min in healthy volunteers and 10 to 125 ng/kg/min in patients with PAH (Figure 1).19, 20 Among healthy volunteers administered treprostinil 10 to 15 ng/kg/min, plasma concentration rose rapidly and reached maximum plasma concentration within 2 to 3 hours after
Patient selection
Treatment decisions are based on clinical measures as well as physician and patient preference, financial considerations (insurance/reimbursement) and experience of the PAH center. Treprostinil is indicated for patients with New York Heart Association Functional Class (FC) II to IV symptoms to diminish symptoms associated with exercise and for patients requiring transition from epoprostenol.26 In practice, SC treprostinil is used in newly diagnosed FC III patients and patients who are
Disclosure statement
Editorial assistance was provided under the direction of the authors by MedThink Communications with support from United Therapeutics Corporation.
M.A.M. received a grant from Actelion Pharmaceuticals, Ltd., to study pulmonary rehabilitation in patients with PAH and he is a consultant to Actelion Pharmaceuticals, Ltd., Gilead Sciences, Inc., and United Therapeutics Corporation. S.M. is an employee of United Therapeutics Corporation. R.S. is a consultant to United Therapeutics Corporation and
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Safety, efficacy and Management of subcutaneous treprostinil infusions in the treatment of severe pediatric pulmonary hypertension
2018, International Journal of CardiologyCitation Excerpt :Changes in the management of SC trepostinil therapy have resulted in a renewed interest in SC therapy [13,14]. There remains a paucity of information to inform the management of continuous SC treprostinil infusions in infants and children despite recent favorable single center case series reports [13–16]. Therefore, we sought to describe the efficacy, tolerability and clinical management from a multicenter review of children treated with continuous SC treprostinil infusions.
Transition from parenteral to oral treprostinil in pulmonary arterial hypertension
2017, Journal of Heart and Lung TransplantationEffect of continuous vs pulsed iontophoresis of treprostinil on skin blood flow
2015, European Journal of Pharmaceutical SciencesCitation Excerpt :Here also we can assume that published data are comforting with a limited risk of systemic effects since in humans significant treprostinil plasma concentration was only detected in two subjects (Roustit et al., 2014), and was lower than that found during iv or sc treprostinil infusion (Laliberte et al., 2004). Moreover, no side effects were observed probably because of a favorable tolerability at such concentrations (Mathier et al., 2010). To confirm these data, forthcoming tolerance experiments with models of SSc-related ulcers should be undertaken.
Capsaicin 8% patch for treprostinil subcutaneous infusion site pain in pulmonary hypertension patients
2014, British Journal of AnaesthesiaCitation Excerpt :Treprostinil improves haemodynamics and shortness of breath associated with physical activity in PAH patients.3 4 The drug can be administered as a continuous i.v. infusion or subcutaneously (s.c.) through a microinfusion pump connected to a catheter implanted under the skin, usually in the abdominal area,5–7 with gradual upward titration based on clinical response and adverse effects.8 9 While treprostinil improves exercise performance, when administered s.c., it can produce severe local pain and neurogenic skin hypersensitivity by stimulating prostacyclin (IP) receptors in skin nociceptor nerve terminals at the site of infusion.5 10
Current and emerging therapies for pulmonary arterial hypertension
2013, Hospital Pharmacy