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Safety and Efficacy of Rapid Transition From Parenetral to Oral Treprostinil

Anil Jonnalagadda

Laura Bryan

Lisa Peters

Julie Dias

Hunter Groninger

Selma Mohammed

Sara Ahmed

Christopher Barnett


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Conference: 2017 PH Professional Network Symposium

Release Date: 10.06.2017

Presentation Type: Abstracts

File Download: 2017 PHPN Abstract 1017

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

Purpose

To determine safety and efficacy of rapid transition from parenteral to oral treprostinil.

Background

Prostanoid therapy is the most efficiacious treatment for pulmonary arterial hypertension (PAH) however the frequently used parenteral delivery systems are inconvenient and require central venous access or subcutaneous infusion catheters that are complex to use and are associated with important complications. The recently approved oral prostanoid, oral treprostinil, represents a potential alternative to parenteral therapy and it may be appropriate in some patients to convert from parenteral to oral treprostinil. Safe transition from parenteral to oral treprositinil has been reported but conversion required 5 days of inpatient observation. We have developed a rapid transition protocol to safely convert patients during a 48-72-hour hospitalization.

Methods

We reviewed medical records to identify patients who had undergone conversion from parenteral to oral therapy and extracted information about adverse effects and hemodynamics before and after conversion.

Results

A total of 6 patients with idiopathic PAH were transitioned from intravenous to oral treprostinil. All of the patients were females aged 26 to 64 years old. Pre-conversion parenteral treprostinil dose was between 15 to 52 ng/kg/min. Conversion required 24hrs in 1 patient and 48 hours in 5 patients 48hrs. Post conversion oral treprostinil dose ranged from 3.25 to 8.625 mg TID. There were no significant changes in vital signs or hemodynamics following conversion and no patients required readmission. No patient experienced significant adverse effects during the conversion period other than headaches and diarrhea which resolved with oral treprostinil dose adjustment.

Conclusion

Rapid transition from parenteral to oral treprostinil is safe and reduces the length of the required hospitalization reducing the cost of the transition as well as the total time patients are exposed to potential complications of hospitalization.