Safety, efficacy and Management of subcutaneous treprostinil infusions in the treatment of severe pediatric pulmonary hypertension

Lévy, Marilyne; Cerro, Maria-Jesus Del; Nadaud, Sophie; Vadlamudi, Karunakar; Colgazier, Elizabeth; Fineman, Jeff; Bonnet, Damien; Adatia, Ian

doi:10.1016/j.ijcard.2018.03.067

Cited by 37 publications

(40 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4,6 It has been reported that 12/56 children (21%) did not respond to simple analgesics, 3 patients used opioids transiently, and there were no patients who stopped treprostinil because of infusion site pain. 1 Pain treatments including local and systemic analgesics may be available and could be used for different intensities of infusion site pain. 5 Although our patient took multiple analgesics (naproxen and acetaminophen) for serious site pain for about 6 months, his pain did not resolve.…”

Section: Discussionmentioning

confidence: 99%

“…There have been several reports on treprostinil sodium (Treprost®, Mochida Pharmaceutical, Japan) for treating children with neonatal and idiopathic pulmonary artery hypertension. [1][2][3] The most noteworthy feature of treprostinil is its ability to be administered subcutaneously as well as intravenously. However, some patients are forced to cease subcutaneous infusion because of severe pain at the infusion site, even when receiving analgesics including opioids.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Using the upper buttocks as a subcutaneous site for treprostinil infusion in children with pulmonary artery hypertension

2020

View full text Add to dashboard Cite

AbstractA 14-year-old boy was receiving subcutaneous infusions of treprostinil for pulmonary artery hypertension. Because he had severe infusion site pain in the lower abdomen, we changed his infusion site to the upper buttocks, adding some analgesics. His pain improved gradually. This change may be an effective method for reducing infusion site pain in subcutaneous treprostinil therapy, particularly in children.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Using the upper buttocks as a subcutaneous site for treprostinil infusion in children with pulmonary artery hypertension

2020

View full text Add to dashboard Cite

show abstract

“…Although transition to subcutaneous treprostinil before discharge has been successful and is becoming a more viable option in infants receiving prostacyclin therapy, our patient was unable to be discharged on this medication; therefore, the decision to undertake the transition to enteral selexipag was made. [1][2][3] Selexipag is the first in a new generation of long-acting enteral selective prostacyclin IP receptor agonists approved for the treatment of pulmonary arterial hypertension in adults. 4 There have been few reports of its use in the children to date.…”

Section: Discussionmentioning

confidence: 99%

Transition from intravenous treprostinil to enteral selexipag in an infant with pulmonary arterial hypertension

Koo

Bock

2019

Cardiol Young

View full text Add to dashboard Cite

show abstract

“…The appearance of hematoma at the subcutaneous infusion site in two of our cases supports the need for monitoring and monthly changes in the device location. 24 Other adverse effects reported in adult patients with PH receiving treprostinil include pain at the infusion site, headache, diarrhea, and flushing. 25 Although it is difficult to corroborate these effects in neonates, switching from intravenous to subcutaneous infusion did not require increased analgesia dose or suspension of the enteric route.…”

Section: Discussionmentioning

confidence: 99%

Neonates Effects and Tolerability of Treprostinil in Hypertension with Persistent Pulmonary

et al. 2019

View full text Add to dashboard Cite

Objective The aim of this study was to establish the effects of treprostinil in congenital diaphragmatic hernia (CDH) patients with persistent pulmonary hypertension (PHT) after 1 week of treatment. Drug effects were assessed by oxygenation index (OI), clinical end points, serial biochemical markers, and pre- and posttreatment echocardiogram. Treatment complications were also described. Study Design This is a quasi-experimental study of neonates with PHT admitted to the NICU within 48 hours showing persistent clinical instability, receiving mechanical ventilation with FiO2 > 60%, milrinone therapy, and inhaled nitric oxide. Clinical data were compared before and after treprostinil treatment. Results Seventeen neonates met the inclusion criteria. Median age was 17 days. Before treatment, median OI was 20 (IQR: 12–27). Suprasystemic PHT was estimated by echocardiogram in 8/17 patients; the rest were systemic. After 1 week of treatment, 15/17 patients were alive and median OI was 8 (IQR: 5–12, p = 0.0089). There were no statistically significant changes in laboratory data. Echocardiogram still showed suprasystemic PHT in 20% of patients. Adverse effects included hypotension, hematoma at the infusion site, and surgical persistent ductus arteriosus (PDA) closure in 4/17 patients. Fourteen patients were discharged. The median treatment time was 61 days. Conclusion Treprostinil was well tolerated with satisfactory clinical response. Further studies are required to identify early responder subgroups.

show abstract

Safety, efficacy and Management of subcutaneous treprostinil infusions in the treatment of severe pediatric pulmonary hypertension

Cited by 37 publications

References 16 publications

Using the upper buttocks as a subcutaneous site for treprostinil infusion in children with pulmonary artery hypertension

Using the upper buttocks as a subcutaneous site for treprostinil infusion in children with pulmonary artery hypertension

Transition from intravenous treprostinil to enteral selexipag in an infant with pulmonary arterial hypertension

Neonates Effects and Tolerability of Treprostinil in Hypertension with Persistent Pulmonary

Contact Info

Product

Resources

About