Orally active prostacyclin analogue in primary pulmonary hypertension

Okano, Yoshiaki; Yoshioka, Toshimasa; Shimouchi, Akito; Satoh, Tsuyoshi; Kunieda, Takeyoshi

doi:10.1016/s0140-6736(97)24019-5

Cited by 121 publications

(56 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Chronic majorvessel TPHis knownto be potentially curable by surgical thromboendarterectomy (8). The present data were all obtained from patients without treatment with newmodalities such as administration of intravenous prostacyclin (9-ll), the usage of its oral analogue (12), nitric oxide inhalation (13) or high oral doses of calcium-channel blockers (14). The present findings thus reveal the inherent prognoses of the two diseases prior to the introduction of new treatments which likely improve the prognosis.…”

Section: Discussionmentioning

confidence: 85%

Prognoses of Primary Pulmonary Hypertension and Chronic Majorvessel Thromboembolic Pulmonary Hypertension Determined from Cumulative Survival Curves.

et al. 1999

Self Cite

View full text Add to dashboard Cite

Object Primary pulmonary hypertension (PPH) has a grave prognosis, and chronic majorvessel thromboembolic pulmonary hypertension (TPH) also has a poor prognosis. The purpose of the study is to elucidate the inherent prognoses of two serious diseases. Methods Thirty-two patients with PPH (aged 33±15 years, 1SD) and 48 patients with TPH (aged 50±14 years, 1SD) were used to determine survival curves using Kaplan and Meier's method from the baseline diagnostic catheterization. Definitive diagnosis was madeby cardiac catheterization, ultrasonic echocardiography, ventilation-per fusion lung scanning, and pulmonary angiography. Results Mean pulmonary artery pressure (PAm) at the initial examination was 56±16 (mean±lSD) mmHg for patients with PPH and 50±13 mmHgfor those with TPH, and did not differ significantly between the two groups. Although these two diseases exhibited equally elevated pulmonary arterial pressures, possibly indicative of a poor prognosis, the survival curves obtained from the prospective study for the two diseases were quite different (p<0.001 by generalized Wilcoxon test, p<0.01 by Log-rank test). Mean survival was calculated to be 3.6 years for PPH and 6.8 years for TPH. Patients with TPHhad a longer survival than those with PPH, despite the fact that the age at diagnosis of PPHwas younger by 17 years on average than that of TPH. Conclusion The inherent prognoses of the two chronic pulmonary hypertensive diseases prior to the introduction of the recently developed new treatment options are shownand likely indicate that the pulmonary vascular lesions in PPHare consistently progressive, while those of TPHare not as progressive. (Internal Medicine 38: 543-546, 1999)

show abstract

Section: Discussionmentioning

confidence: 85%

Prognoses of Primary Pulmonary Hypertension and Chronic Majorvessel Thromboembolic Pulmonary Hypertension Determined from Cumulative Survival Curves.

et al. 1999

Self Cite

View full text Add to dashboard Cite

show abstract

“…These effects are shown by the fact that the ratio of pulmonary to systemic vascular resistance, that is pulmonary vascular resistance divided by systemic vascular resistance, initially increases in the acute short-term period, but then decreases in the chronic long-term period. 15,23,24) This is why the effects of newly developed pulmonary vasodilators were once regarded as a miracle or a mystery for the treatment of pulmonary hypertension. Since lesions are observed in most of the pulmonary vascular system from the tunica intima and media to the adventitia, conventional vasodilators are only effective for the systemic vasculature and show almost no effect on the pulmonary vasculature.…”

Section: Discussionmentioning

confidence: 99%

“…14) Compared with the conventional beraprost preparation, [15][16][17][18] which was approved for treating I-PAH in 1999 in Japan, TRK-100STP has a slower release of beraprost sodium. This allows treatment at higher daily doses by maintaining optimal maximum plasma concentration and prolonging the duration of an effective plasma concentration of beraprost sodium.…”

mentioning

confidence: 99%

Effects of Long-Acting Beraprost Sodium (TRK-100STP) in Japanese Patients With Pulmonary Arterial Hypertension

et al. 2009

Self Cite

View full text Add to dashboard Cite

SummaryThe long-acting beraprost preparation TRK-100STP is formulated to provide sustained release of an orally active prostacyclin derivative to maintain the optimal plasma concentration for a longer period of time compared with the currently used conventional beraprost sodium. In the present study, we evaluated the efficacy of this newly developed formulation for pulmonary arterial hypertension (PAH).An open-label, 12-week multicenter clinical trial was performed in 46 patients with PAH. They were initially treated with 120 μg of TRK-100STP divided into 60 μg twice daily, followed by a stepwise increase to 360 μg given as 180 μg twice daily. The 6-minute walking distance showed a significant increase by 33.4 ± 66.0 m (95% confidence interval [CI], 13.4 to 53.5) from the baseline measurement. Mean pulmonary artery pressure, total pulmonary vascular resistance, and pulmonary vascular resistance decreased by −2.8 ± 5.5 mmHg (95% CI, −4.6 to −1.0), by −0.92 ± 2.63 mmHg•L •min (95% CI, −1.84 to 0.06), respectively, from the baseline measurements. A higher efficacy was observed in patients with a maximum tolerated dose of 360 μg daily than those of 240 μg daily or less.Treatment with TRK-100STP for a 12-week period improved the exercise capacity,From the

show abstract

“…Because of its complexity, epoprostenol therapy should be given in centers experienced with its administration. Beraprost is an orally active prostacyclin analogue (61). In a 12-week trial done in patients with PAH in NYHA functional class II and III, beraprost increased the 6-min walking distance without substantially affecting cardiopulmonary hemodynamic variables or survival (62).…”

Section: Prostanoidsmentioning

confidence: 99%

Evaluation and Management of the Patient with Pulmonary Arterial Hypertension

Rubin

Badesch²

2005

Ann Intern Med

126

View full text Add to dashboard Cite

Increased pressure in the pulmonary circulation, or pulmonary hypertension, is a common disorder that may complicate various cardiopulmonary conditions, including severe obstructive airways disease and left ventricular dysfunction. An increase in pulmonary arterial pressure that is not due to coexistent cardiopulmonary disease, known as pulmonary arterial hypertension, may occur in the absence of a demonstrable cause (idiopathic or familial); as a complication of systemic conditions, such as connective tissue disease, HIV infection, or chronic liver disease; or as a result of the use of fenfluramine anorexigens, amphetamines, or cocaine. The development of disease-specific therapies for pulmonary arterial hypertension over the past decade underscores the importance of diagnosing pulmonary hypertension early in the course of the condition and implementing a treatment strategy that is based on the condition's cause and severity. In this review, the authors present approaches to the diagnosis and management of pulmonary arterial hypertension, using a hypothetical case to highlight the key management points. U ntil recently, management of pulmonary arterial hypertension (PAH) was generally ineffective in alleviating symptoms or improving survival. However, the past decade has witnessed remarkable advances in our understanding of the pathogenesis of PAH, advances that have led to the development of disease-specific treatments. Despite these achievements, PAH remains a challenging condition to diagnose and manage. This article reviews recent developments in the diagnosis and management of PAH in the context of a typical case, illustrating the importance of collaboration between the internist and the specialist in patient care.

show abstract

Orally active prostacyclin analogue in primary pulmonary hypertension

Cited by 121 publications

References 4 publications

Prognoses of Primary Pulmonary Hypertension and Chronic Majorvessel Thromboembolic Pulmonary Hypertension Determined from Cumulative Survival Curves.

Prognoses of Primary Pulmonary Hypertension and Chronic Majorvessel Thromboembolic Pulmonary Hypertension Determined from Cumulative Survival Curves.

Effects of Long-Acting Beraprost Sodium (TRK-100STP) in Japanese Patients With Pulmonary Arterial Hypertension

Evaluation and Management of the Patient with Pulmonary Arterial Hypertension

Contact Info

Product

Resources

About