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Rapid Transition Between Intravenous and Subcutaneous Treprostinil Infusions

Laura Duvall


Leila Norris

Namita Sood


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Conference: 2014 International PHA Conference and Scientific Sessions

Release Date: 06.22.2014

Presentation Type: Abstracts

File Download: 2014 Conference Abstract - Laura Duvall

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Treprostinil is a prostacyclin analog used for the long-term intravenous treatment of pulmonary arterial hypertension and pulmonary hypertension to diminish symptoms associated with exercise and for patients who require transition from epoprostenol therapy secondary to clinical deteriation.

Background: Treprostinil is a prostacyclin analog used for the long-term intravenous treatment of pulmonary arterial hypertension and pulmonary hypertension to diminish symptoms associated with exercise and for patients who require transition from epoprostenol therapy secondary to clinical deteriation. Treprostinil has a half-life of approximately 4 hours and narrow dosing parameters. The medication is administered as a continuous infusion either intravenously or subcutaneously. Per policy, administration of subcutaneous treprostinil therapy at The Ohio State University Wexner Medical Center (OSUWMC) requires the patient to be mentally and physically able to operate their own home infusion pump or they will be transitioned to intravenous therapy during their admission. There is very little published data about how to transition patients between intravenous and subcutaneous therapies, and no studies specifically looking at treprostinil therapy alone.  Currently published data on how to transition these therapies describe a gradual titration process whereas one therapy is increased while the other therapy is concomitantly decreased. Our current process at OSUWMC is to rapidly transition between subcutaneous and intravenous treprostinil by discontinuing one route of administration and initiating the other route of administration at the same time. We transition this way whether the desired transition is from subcutaneous to intravenous or vice versa.

Methods: A retrospective chart was conducted to collect data on patients who have received treprostinil therapy by both subcutaneous and intravenous routes of administration during a single admission in the study period. Eligible patients are those admitted to The Ohio State University Wexner Medical Center between January 1, 2011 and December 31, 2013 on subcutaneous or intravenous treprostinil therapies. 

Results: Ten patients met inclusion criteria for this study. In each case the patient had a rapid transition between intravenous and subcutaneous treprostinil administration. Final study results are currently pending, however information being collected includes demographics, dosing, adverse effects (hypotension, nausea/vomiting, diarrhea, flushing, and headache), and length of stay.

Conclusions: To be determined based on results of data collection, however clinical experience yields that rapid transition between intravenous and subcutaneous treprostinil infusions has been very successful.  

Type: Case Study