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Ventavis to Selexipag Conversion

Kimberley Litton

Kimberly Curry

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Conference: 2018 PHA International PH Conference & Scientific Sessions

Release Date: 06.28.2018

Presentation Type: Abstracts

File Download: Conference 2018_1069

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2018 International PH Conference and Scientific SeAbstract presented at the 2018 International PH Conference and Scientific Sessions in Orlando, Fla., June 28-July 1, 2018.

Purpose

58 yr old female PAH patient. She has stable WHO functional class I- II symptoms secondary to her pulmonary hypertension and right ventricular dysfunction. She denies any secondary effects from Ventavis. Patient reports that being on Ventavis is inconvenient and negatively impacts her daily life.

Background

57 y.o. female who has a history of pulmonary hypertension with a BMP O2 mutation that was initially diagnosed in April of 2003. Patient first diagnosed with pulmonary hypertension in April of 2003 after having several months of increasing shortness of breath. Was diagnosed with severe pulmonary hypertension by right heart catheterization as well as a left main compression by her main pulmonary artery. She required urgent treatment with IV prostacyclin in June 2003. She requested to come off her IV prostacyclin and was transitioned to Ventavis in 2007. She was also started on Sildenafil in 2015, after worsening of her PAH noted by TTE/echocardiogram Patient currently has no shortness of breath at rest or with her daily activities of living. She has no shortness of breath walking a block or flight of stairs. She denies orthopnea PND, but does have mild lower extremity edema. She denies syncope, presyncope, exertional lightheadedness or palpitations. Over the past 11 years, she has been about 90% compliant with her Ventavis inhalations. Patient requested to be transitioned to oral prostacyclin, so plan was developed and currently in process of transitioning pt.

Methods

1) Met with PHARMD to discuss the patients plan and medication transition. PharmD developed the transition plan from Ventavis to Selexipag 2) Prior Authorization and arranging the Medication 3) Meeting with Patient/Medical Provider/PharmD and RN Clinical Coordinator and providing one on one education 4) PLAN over eight (8) weeks

Results

1) There is no published data on this specific transition. There is a case report on Tyvaso to Selexipag and there is a study, TRANSIT 1., looking at converting patients from Tyvaso to Selexipag. 2) Plan has been developed and currently in the process of transitioning the patient from the Ventavis to Selexipag 3) Patient progress and tolerance will be monitored closely 4) Will closely monitor patient and do vital sign monitoring/6MWT and 3 month post transition will perform a Right Heart Cath.

Conclusions

1) Currently in the process of collecting the data 2) Results and how the patient tolerated the transition have not been finalized. Results will be posted at the end of the transition period, as well as the clinical signs/symptoms and 6MWT and RHC results.