Advances in Therapy

, Volume 28, Issue 4, pp 251–269

Prostacyclins in pulmonary arterial hypertension: the need for earlier therapy

Review

DOI: 10.1007/s12325-011-0005-5

Cite this article as:
Vachiéry, JL. Adv Therapy (2011) 28: 251. doi:10.1007/s12325-011-0005-5
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Abstract

Pulmonary arterial hypertension (PAH) is a rare but serious condition, which if untreated, is associated with a 2–3-year median survival time. A number of treatment options are available for PAH, leading to improvements in exercise capacity, symptoms, and hemodynamics. However, the disease remains incurable and most patients will ultimately progress to right heart failure and death. Three classes of drugs are currently available to improve PAH outcomes, although this review will focus solely on a class of potent vasodilators known as prostacyclins. Currently, four prostacyclin analogs are licensed for the treatment of PAH: epoprostenol, treprostinil, and iloprost in the USA and some European countries, and beraprost in Japan and Korea. Prostacyclins have become the treatment of choice in patients with severe PAH, but there is also evidence to suggest that their earlier use may also benefit patients with mild-to-moderate disease. This review discusses the advantages of prostacyclins in terms of their usefulness in patients whose condition has deteriorated following monotherapy with other agents, and their integral role in combination therapy. The latter appears to offer the potential for pulmonary vasculature remodeling and could be regarded as an emerging paradigm to treat and prevent the progression of PAH.

Keywords

beraprost epoprostenol iloprost prostacyclin pulmonary arterial hypertension treprostinil 

Copyright information

© Springer Healthcare 2011

Authors and Affiliations

  1. 1.Pulmonary Vascular Diseases and Heart Failure Clinic, Department of CardiologyCUB-Hôpital ErasmeBrusselsBelgium

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