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首页> 外文期刊>Pulmonary Circulation >Long-Term Therapy with Oral Treprostinil in Pulmonary Arterial Hypertension Failed to Lead to Improvement in Important Physiologic Measures: Results from a Single Center:
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Long-Term Therapy with Oral Treprostinil in Pulmonary Arterial Hypertension Failed to Lead to Improvement in Important Physiologic Measures: Results from a Single Center:

机译：口服曲前列环素治疗肺动脉高压的长期治疗未能导致重要的生理指标改善：来自单个中心的结果：

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Sustained-release oral treprostinil, an oral prostacyclin, led to significant improvement in 6-minute walk distance (6MWD) versus placebo in treatment-naive patients with pulmonary arterial hypertension (PAH) but failed to lead to significant improvement in two 16-week trials in patients receiving background PAH therapies (FREEDOM studies). Long-term studies are lacking. Our objective was to evaluate 6MWD, functional class, hemodynamics, and other long-term outcomes during oral treprostinil administration in PAH. Patients receiving oral treprostinil through the FREEDOM studies at our institution were included and were followed for up to 7 years. The primary end point was change in pulmonary vascular resistance (PVR) at first follow-up catheterization. Other end points included 6MWD, functional class, and other hemodynamic results. Thirty-seven patients received oral treprostinil for a median of 948 days, with 81%, 61%, and 47% continuing therapy at 1, 2, and 3 years, respectively. Mean treprostinil dose at 3, 12, and 24 months was 4.3 ± 2.3, 8.6 ± 3.2, and 11.7 ± 5.8 mg/24 h, respectively. Compared with pretreatment values, there was no significant change in 6MWD at 3 or 12 months, no improvement in functional class at 12 months, and no significant change in hemodynamics at the first follow-up catheterization (N = 34). Oral treprostinil dose was inversely associated with change in PVR (r = ?0.42, P 0.05), and change in PVR was numerically better among patients in the highest dosing quartile. No significant improvement in 6MWD, functional class, or hemodynamics versus pretreatment values was seen with long-term oral treprostinil therapy, potentially because of inability to achieve a clinically effective dose.
机译：与未经安慰剂治疗的肺动脉高压（PAH）患者相比，口服前列环素缓释口服曲前列环素（口服前列环素）可使6分钟步行距离（6MWD）显着改善，但未能导致两项16周试验的显着改善接受背景PAH疗法的患者（免费研究）。缺乏长期研究。我们的目标是评估在PAH口服曲前列环素期间6MWD，功能类别，血液动力学和其他长期结果。通过我们机构的FREEDOM研究接受口服曲前列环素的患者被纳入研究，随访时间长达7年。主要终点是首次随访导管插入时肺血管阻力（PVR）的变化。其他终点包括6MWD，功能类别和其他血液动力学结果。三十七名患者接受口服曲前列环素治疗，中位时间为948天，分别在1、2和3年时分别接受了81％，61％和47％的持续治疗。在3、12和24个月时曲前列环素的平均剂量分别为4.3±2.3、8.6±3.2和11.7±5.8 mg / 24 h。与治疗前的值相比，在第3或12个月时6MWD无明显变化，在第12个月时功能类别无改善，在首次随访导管插入时的血流动力学无明显变化（N = 34）。口服曲前列素剂量与PVR的变化呈负相关（r = 0.42，P <0.05），在最高剂量四分位数的患者中，PVR的变化在数值上更好。与长期口服曲前列环素治疗相比，与预治疗值相比，6MWD，功能分类或血流动力学没有明显改善，这可能是由于无法达到临床有效剂量所致。

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