Pulmonary Vascular Disease |

Transitioning Patients With Pulmonary Arterial Hypertension From Intravenous 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):935A. doi:10.1378/chest.2281237
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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 the severity, etiology, and patient preferences. 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 IV prostacyclin therapies to oral treprostinil.

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

RESULTS: A total of 6 patients (mean age 68.6 years [range 47-82], 3 females) with PAH (2 idiopathic, 4 congenital heart disease) were transitioned from IV prostacyclin therapy to oral treprostinil therapy. Of the 6 patients transitioned, 1 was due to repeat line infections, 4 for patient preference, and 1 secondary to side effects. All patients were transitioned using our center’s specific protocol. Of the 6 patients transitioned to oral treprostinil, 4 were transitioned from IV treprostinil and 2 from IV epoprostenol. One patient discontinued oral treprostinil due to side effects related to inability to comply with calorie requirements. There was one death unrelated to transition.

CONCLUSIONS: In this small case series we were able to demonstrate that select patients can safely transition from IV to oral prostacyclin therapy using our short inpatient transition protocol. The one patient failure was attributed to inability to maintain caloric requirements for effective oral dosing.

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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