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Transitioning intravenous epoprostenol to oral selexipag in idiopathic pulmonary arterial hypertension: a case report

2023-08Journal article Open access
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dc.contributor.authorAlexandre, André
dc.contributor.authorFurtado, Inês
dc.contributor.authorGonçalves, Fabienne
dc.contributor.authorGonçalves, Fabienne
dc.contributor.authorMelo, Alzira
dc.contributor.authorAlves, Joana
dc.contributor.authorSantos, Mario
dc.contributor.authorReis, Abilio
dc.date.accessioned2024-07-04T08:49:22Z
dc.date.available2024-07-04T08:49:22Z
dc.date.issued2023-08
dc.description.abstractIntravenous (i.v.) prostacyclin is the cornerstone treatment in high-risk pulmonary arterial hypertension (PAH) patients. Selexipag is an orally available prostacyclin receptor agonist. Limited data are available regarding the feasibility of transitioning from i.v. epoprostenol to selexipag. A 50-year-old woman with idiopathic PAH was diagnosed in a World Health Organization (WHO) Functional Class (FC) IV. She improved with upfront triple combination therapy, including i.v. epoprostenol. Over 2 years of follow-up, the patient remained at low risk and expressed strong preference towards oral therapies. After careful risk-benefit clinical consideration, she was transitioned from i.v. epoprostenol to selexipag. Selexipag was started at dosage of 200 μg twice daily (b.i.d.) and titrated up to 1600 μg b.i.d. over 8 weeks (up-titration of 200 μg b.i.d. every week). Simultaneously, i.v. epoprostenol was down-titrated 3.0 ng/kg/min every week from a dosage of 27.5 ng/kg/min. The transition occurred under strict medical surveillance and was well tolerated. One year after discontinuation of epoprostenol, the patient remains in WHO FC I and has no signs of clinical deterioration. Although not generalizable to most PAH patients, this case highlights that a carefully planned transition from epoprostenol to selexipag is feasible in selected low-risk patients within a shared medical decision-making framework.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAlexandre A, Furtado I, Carvalho L, et al. Transitioning intravenous epoprostenol to oral selexipag in idiopathic pulmonary arterial hypertension: a case report. ESC Heart Fail. 2023;10(4):2722-2727. doi:10.1002/ehf2.14428pt_PT
dc.identifier.doi10.1002/ehf2.14428pt_PT
dc.identifier.issn2055-5822
dc.identifier.urihttp://hdl.handle.net/10400.16/2990
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.relation.publisherversionhttps://doi.org/10.1002/ehf2.14428pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectIdiopathic pulmonary arterial hypertensionpt_PT
dc.subjectIntravenous epoprostenolpt_PT
dc.subjectOral selexipagpt_PT
dc.subjectPulmonary hypertensionpt_PT
dc.subjectSwitchback therapypt_PT
dc.subjectTransition therapypt_PT
dc.titleTransitioning intravenous epoprostenol to oral selexipag in idiopathic pulmonary arterial hypertension: a case reportpt_PT
dc.title.alternativeJohn Wiley & Sons Ltdpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceEnglandpt_PT
oaire.citation.endPage2727pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage2722pt_PT
oaire.citation.titleESC Heart Failurept_PT
oaire.citation.volume10pt_PT
person.familyNameAlexandre
person.familyNameFurtado
person.familyNameGonçalves
person.familyNameSantos
person.familyNameReis
person.givenNameAndré
person.givenNameInês
person.givenNameFabienne
person.givenNameMario
person.givenNameAbilio
person.identifier.ciencia-idAD16-41FC-2E98
person.identifier.ciencia-idCF14-7C6C-0B6B
person.identifier.ciencia-idCB17-AD56-DE37
person.identifier.ciencia-idBC10-897E-BE36
person.identifier.orcid0000-0003-2465-2217
person.identifier.orcid0000-0003-3985-0718
person.identifier.orcid0000-0002-3439-5093
person.identifier.orcid0000-0002-4509-0260
person.identifier.orcid0000-0002-9932-3736
person.identifier.ridADZ-9161-2022
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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