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Subcutaneous treprostinil in pulmonary arterial hypertension: Practical considerations.
J Heart Lung Transplant. 2010 Nov; 29(11):1210-7.JH

Abstract

Treprostinil, which is available for subcutaneous (SC) and intravenous (IV) administration, has demonstrated efficacy in increasing exercise capacity, reducing signs and symptoms of pulmonary arterial hypertension (PAH), and improving cardiopulmonary hemodynamics in patients with PAH; however, the infusion site pain commonly experienced with SC treprostinil has limited its use. Prospective and observational clinical studies have shown that the dose of SC treprostinil can be escalated at a higher rate than described in early clinical trials to achieve symptom relief, in part because of favorable tolerability of treatment and the apparent dose independence of site pain. In addition, pain management protocols that include non-pharmacologic and pharmacologic (i.e., topical and systemic) approaches provide analgesic relief from infusion site pain. With experience, physicians and patients have recognized that some infusion sites are better than others, and the frequency of site rotation can be reduced to improve tolerability. Dosing to achieve rapid onset of efficacy and proactively managing infusion site pain enhance the likelihood for a patient with PAH to maintain and derive benefit from SC treprostinil therapy.

Authors+Show Affiliations

Cardiovascular Institute, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213, USA. mathierm@upmc.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20855220

Citation

Mathier, Michael A., et al. "Subcutaneous Treprostinil in Pulmonary Arterial Hypertension: Practical Considerations." The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, vol. 29, no. 11, 2010, pp. 1210-7.
Mathier MA, McDevitt S, Saggar R. Subcutaneous treprostinil in pulmonary arterial hypertension: Practical considerations. J Heart Lung Transplant. 2010;29(11):1210-7.
Mathier, M. A., McDevitt, S., & Saggar, R. (2010). Subcutaneous treprostinil in pulmonary arterial hypertension: Practical considerations. The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, 29(11), 1210-7. https://doi.org/10.1016/j.healun.2010.06.013
Mathier MA, McDevitt S, Saggar R. Subcutaneous Treprostinil in Pulmonary Arterial Hypertension: Practical Considerations. J Heart Lung Transplant. 2010;29(11):1210-7. PubMed PMID: 20855220.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Subcutaneous treprostinil in pulmonary arterial hypertension: Practical considerations. AU - Mathier,Michael A, AU - McDevitt,Susanne, AU - Saggar,Rajan, Y1 - 2010/09/19/ PY - 2009/08/26/received PY - 2010/06/24/revised PY - 2010/06/25/accepted PY - 2010/9/22/entrez PY - 2010/9/22/pubmed PY - 2011/3/2/medline SP - 1210 EP - 7 JF - The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation JO - J. Heart Lung Transplant. VL - 29 IS - 11 N2 - Treprostinil, which is available for subcutaneous (SC) and intravenous (IV) administration, has demonstrated efficacy in increasing exercise capacity, reducing signs and symptoms of pulmonary arterial hypertension (PAH), and improving cardiopulmonary hemodynamics in patients with PAH; however, the infusion site pain commonly experienced with SC treprostinil has limited its use. Prospective and observational clinical studies have shown that the dose of SC treprostinil can be escalated at a higher rate than described in early clinical trials to achieve symptom relief, in part because of favorable tolerability of treatment and the apparent dose independence of site pain. In addition, pain management protocols that include non-pharmacologic and pharmacologic (i.e., topical and systemic) approaches provide analgesic relief from infusion site pain. With experience, physicians and patients have recognized that some infusion sites are better than others, and the frequency of site rotation can be reduced to improve tolerability. Dosing to achieve rapid onset of efficacy and proactively managing infusion site pain enhance the likelihood for a patient with PAH to maintain and derive benefit from SC treprostinil therapy. SN - 1557-3117 UR - https://www.unboundmedicine.com/medline/citation/20855220/Subcutaneous_treprostinil_in_pulmonary_arterial_hypertension:_Practical_considerations_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1053-2498(10)00431-6 DB - PRIME DP - Unbound Medicine ER -