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Transitioning Patients with Pulmonary Arterial Hypertension from Subcutaneous Treprostinil to Intravenous Treprostinil: Single-Center Experience

S. Paulus

N. Niebauer

Tammy Freichels

Dianne Zwicke


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Conference: 2017 PH Professional Network Symposium

Release Date: 10.06.2017

Presentation Type: Abstracts

File Download: 2017 PHPN Abstract 1014

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Abstract presented at the 2017 PH Professional Network Symposium held in Bethesda, MD on October 5-7, 2017

Purpose

Evaluation of our patients transitioned from subcutaneous (SQ) treprostinil to intravenous (IV) treprostinil.

Background

Pulmonary Arterial Hypertension (PAH) is a devastating disease with multiple therapy options. Several prostacyclin therapy options are available depending on the patient’s PAH etiology, disease severity, and preference. We report our single-center experience transitioning patients with PAH from subcutaneous (SQ) treprostinil to intravenous (IV) treprostinil.

Methods

We retrospectively reviewed charts of patients transitioned from SQ treprostinil to IV treprostinil from April 2010 through September 2015.

Results

A total of 4 patients (mean age 44 years [range 32-56], 4 females) with PAH (1 idiopathic, 1 collagen vascular disease, 1 congenital heart disease, 1 portal hypertension) transitioned from SQ treprostinil to IV treprostinil. Of the 4 patients transitioned, 3 were due to site pain and 1 due to need for higher prostacyclin dosing because of declining status. Average dose of SQ treprostinil before transition was 49.3 ng [range 15-100 ng] and average dose of IV treprostinil after transition was 37 ng [range 8-78 ng]. After transition, the site pain resolved in 3 patients experiencing it. The one patient transitioned due to declining status has improved to an NYHA class II on IV treprostinil.

Conclusion

In this small case series we were able to demonstrate that patients can safely transition from SQ treprostinil to IV treprostinil. IV treprostinil can be an alternative parenteral prostacyclin therapy if patients are experiencing site pain from SQ treprostinil. The one patient with a declining functional status improved once transitioned to IV treprostinil. IV treprostinil can be a safe and beneficial alternative to SQ treprostinil. It provided relief from site pain in multiple patients and provided higher prostacyclin dosing to improve the functional status of one patient. Further study is required to validate these benefits in larger populations.