Combination therapy in the management of pulmonary arterial hypertension

Buckley, Mitchell S.; Staib, Robin L; Wicks, Laura M.

doi:10.1111/ijcp.12136

Cited by 17 publications

(11 citation statements)

References 32 publications

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“…Schistosomal pulmonary hypertension is diagnosed in approximately 10% of the patients with hepatosplenic schistosomiasis [48][49][50][51] ; the use of pulmonary vasodilators has greatly improved the survival and quality of life of those patients [52][53][54][55] .…”

Section: Complications Of Hepatosplenic Schistosomiasismentioning

confidence: 99%

Revisiting the concept of hepatosplenic schistosomiasis and its challenges using traditional and new tools

Lambertucci

2014

Rev. Soc. Bras. Med. Trop.

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Different aspects of hepatosplenic schistosomiasis are revisited here. Manson's schistosomiasis causes periportal fi brosis and portal hypertension in approximately 6% of infected subjects, usually with preservation of their hepatic function. The assessment of liver involvement is of major importance in determining the prognosis and risk of complications from schistosomiasis, such as upper digestive bleeding secondary to variceal rupture. For many years, the diagnosis of hepatosplenic schistosomiasis and liver fi brosis was made by abdominal palpation and the fi nding of liver and/or spleen enlargement. However, there is no consensus regarding the clinical parameters of the liver and spleen to be considered in this physical evaluation. For the last three decades, abdominal ultrasound (US) has become the best imaging technique to evaluate liver fi brosis caused by schistosomiasis mansoni. However, US is a subjective procedure and is therefore examiner-dependent. Magnetic resonance imaging (MRI) fi ndings have provided valuable information in addition to ultrasound and clinical examination. The combination of a comprehensive history and physical examination, basic laboratory tests (a stool examination for Schistosoma mansoni eggs and a blood cell count), biomarkers for liver fi brosis/portal hypertension and imaging methods seem to offer the best approach for evaluating patients with this disease. In situations where research is involved or in patients with severe disease, MRI may be considered.

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Section: Complications Of Hepatosplenic Schistosomiasismentioning

confidence: 99%

Revisiting the concept of hepatosplenic schistosomiasis and its challenges using traditional and new tools

Lambertucci

2014

Rev. Soc. Bras. Med. Trop.

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“…As the techniques used in PH therapy continue to improve, several types of drug have come onto the market, and these have dramatically improved quality of life and prognosis . Furthermore, combination therapies are frequently being applied and show favorable results . There are major differences, however, in renal function, metabolism, and absorption in children compared with adults .…”

Section: Discussionmentioning

confidence: 99%

“…The development of these drugs has dramatically improved the prognosis of PH . Both monotherapy and combination therapy have contributed to improvement in outcome …”

mentioning

confidence: 99%

Pharmacokinetics of drugs for pediatric pulmonary hypertension

Nakau

Sugimoto

Oka

et al. 2016

Pediatrics International

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“…Results from a recent meta-analysis could not show any beneficial effect of sequential combination therapy on a combined end point of mortality, admission for PAH worsening, and lung transplantation when compared to monotherapy [51]. While combination therapy has been shown to be relatively safe and well tolerated [52], further large-scale, long-term, prospective studies are required to define its efficacy in PAH [51]. The first robust evidence of the effect of sequential combination therapy on long-term outcomes has come from the SERAPHIN trial [41].…”

Section: Endothelin Receptor Antagonists In Combination With Other Thmentioning

confidence: 99%

Pathways and Drugs in Pulmonary Arterial Hypertension – Focus on the Role of Endothelin Receptor Antagonists

Madonna

Cocco²,

Caterina

2015

Cardiovasc Drugs Ther

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Pulmonary arterial hypertension (PAH) is a group of diseases characterized by a progressive increase of pulmonary vascular resistance (PVR), initially due to abnormal pulmonary vasoconstriction in response to endothelial injury. Recent studies have here confirmed the prominent role of endothelin (ET)-1 in vasoconstriction and remodelling of the pulmonary microcirculation. In patients who are acute-vasoreactive, classical treatments for PAH are calcium channels blockers (CCBs), while drugs targeting the prostacyclin, nitric oxide and endothelin pathways, i.e., prostanoids, phosphodiesterase (PDE)-5 inhibitors and endothelin receptor antagonists (ERAs), respectively, are indicated in non-vasoreactive patients or in vasoreactive patients not responding to initial CCB therapy. Randomised, placebo-controlled trials have shown that ERAs improve pulmonary haemodynamics, exercise capacity, functional status and clinical outcome in patients with PAH. Here we provide an overview of the currently recommended diagnostic and therapeutic work-up in PAH, with special emphasis on ERAs.

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Combination therapy in the management of pulmonary arterial hypertension

Cited by 17 publications

References 32 publications

Revisiting the concept of hepatosplenic schistosomiasis and its challenges using traditional and new tools

Revisiting the concept of hepatosplenic schistosomiasis and its challenges using traditional and new tools

Pharmacokinetics of drugs for pediatric pulmonary hypertension

Pathways and Drugs in Pulmonary Arterial Hypertension – Focus on the Role of Endothelin Receptor Antagonists

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