Pulmonary Vascular Disease |

Transitioning Patients With Pulmonary Arterial Hypertension From Inhaled Prostacyclin to Oral Prostacyclin: Single-Center Experience FREE TO VIEW

Sara Paulus, PA-C; Adam Kallio, RN; Eric Roberts, MD; Frank Spexarth, RPh; Dianne Zwicke, MD
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Aurora Cardiovascular Services, Aurora St. Luke's Medical Center, Milwaukee, WI

Chest. 2015;148(4_MeetingAbstracts):936A. doi:10.1378/chest.2281198
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SESSION TITLE: Pulmonary Arterial Hypertension Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Pulmonary Arterial Hypertension is a devastating disease with various treatment options dependent on many factors. An oral prostacyclin has been approved for treatment of PAH, but no guidelines exist for transitioning patients to this therapy. We report our single-center experience transitioning patients with PAH from inhaled treprostinil to oral treprostinil.

METHODS: We retrospectively reviewed charts of patients transitioned from inhaled treprostinil to oral treprostinil from June 2014 through March 2015.

RESULTS: A total of 22 patients (mean age 61.1 years [range 21-86], 16 females) with PAH (7 idiopathic, 7 congenital heart disease, 8 collagen vascular disease) were transitioned from inhaled treprostinil therapy to oral treprostinil therapy. Reasons for transition included: cough - 13, higher dose - 4, and convenience was cited by 5. All patients were transitioned using our center’s specific protocol. Twenty patients were dosed 3 times daily, 1 patient twice daily, and 1 patient went from 3 times daily to twice daily. Of the 22 patients transitioned, 6 discontinued oral treprostinil. Reasons for discontinuation included: inability to comply with dosing - 2, higher dosing required than tolerated orally - 1, side effects - 2, therapy no longer required - 1. There was one death unrelated to disease state/transition.

CONCLUSIONS: In this small case series we were able to demonstrate that select patients can safely transition from inhaled to oral prostacyclin therapy using our center's transition protocol. Twice daily dosing improved patient compliance with the calorie requirements. Patients unable to comply with calorie requirements failed oral treprostinil treatment.

CLINICAL IMPLICATIONS: Larger studies and longer durations of clinical follow up are required to validate oral treprostinil transition protocols. Further study is required to evaluate the impact of caloric intake on the durability of oral treprostinil therapy.

DISCLOSURE: The following authors have nothing to disclose: Sara Paulus, Adam Kallio, Eric Roberts, Frank Spexarth, Dianne Zwicke

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