Abstract
Over the past decade different effective treatment options for use in pulmonary arterial hypertension (PAH) have been developed. Due to multiple pathophysiological pathways in PAH and unsatisfactory overall results with the use of monotherapy in a substantial number of PAH patients, there is a pharmacological rationale for combination therapy. The currently approved substances target the prostacyclin, the endothelin and the NO (nitric oxide) -pathways. Those agents have shown a varying degree of improvement in different categories of PAH associated limitations like hemodynamics, exercise capacity, functional class, and quality of life. However, clinical worsening over time is still significant in most patients irrespective of the treatment utilized. The recently published ESC-ERS (European Society of Cardiology and European Respiratory Society) guidelines on pulmonary hypertension suggest the use of combination therapy in patients who do not respond adequately to monotheapy. This article reviews and critically discusses the available data on combination therapy in PAH.
Keywords: Combination therapy, endothelin receptor antagonists, phosphodiesterase-5-inhibitors, prostanoids, pulmonary hypertension, randomized controlled trials, open-label, nitric oxide, epoprostenol
Current Vascular Pharmacology
Title: Pulmonary Hypertension: Role of Combination Therapy
Volume: 9 Issue: 4
Author(s): Tobias Meis and Juergen Behr
Affiliation:
Keywords: Combination therapy, endothelin receptor antagonists, phosphodiesterase-5-inhibitors, prostanoids, pulmonary hypertension, randomized controlled trials, open-label, nitric oxide, epoprostenol
Abstract: Over the past decade different effective treatment options for use in pulmonary arterial hypertension (PAH) have been developed. Due to multiple pathophysiological pathways in PAH and unsatisfactory overall results with the use of monotherapy in a substantial number of PAH patients, there is a pharmacological rationale for combination therapy. The currently approved substances target the prostacyclin, the endothelin and the NO (nitric oxide) -pathways. Those agents have shown a varying degree of improvement in different categories of PAH associated limitations like hemodynamics, exercise capacity, functional class, and quality of life. However, clinical worsening over time is still significant in most patients irrespective of the treatment utilized. The recently published ESC-ERS (European Society of Cardiology and European Respiratory Society) guidelines on pulmonary hypertension suggest the use of combination therapy in patients who do not respond adequately to monotheapy. This article reviews and critically discusses the available data on combination therapy in PAH.
Export Options
About this article
Cite this article as:
Meis Tobias and Behr Juergen, Pulmonary Hypertension: Role of Combination Therapy, Current Vascular Pharmacology 2011; 9 (4) . https://dx.doi.org/10.2174/157016111796197242
DOI https://dx.doi.org/10.2174/157016111796197242 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Low Estimated Glomerular Filtration Rate is Associated with High Recurrence Rate and Poor Prognosis of Hemorrhage Stroke
Current Neurovascular Research Milk Fat Globule Epidermal Growth Factor VIII Signaling in Arterial Wall Remodeling
Current Vascular Pharmacology Benzodiazepines, Amphetamines, Testosterone, and Sildenafil as New Candidate Drugs for Sexual Interest, Desire and/or Arousal Disorder
Current Psychopharmacology Young Stroke Patients Treated with Intravenous Thrombolysis have a More Favorable Outcome and Mortality Compared with Older Patients
Current Neurovascular Research Safety Profile of Oral Iron Chelator Deferiprone in Chinese Children with Transfusion-Dependent Thalassaemia
Current Drug Safety miR-126 as a Therapeutic Agent for Diabetes Mellitus
Current Pharmaceutical Design High Throughput Screening for Orphan and Liganded GPCRs
Combinatorial Chemistry & High Throughput Screening Role of Antioxidants in Redox Regulation of Diabetic Cardiovascular Complications
Current Pharmaceutical Biotechnology Executive Dyscontrol in Dementia, with Emphasis on Subcortical Pathology and the Role of Butyrylcholinesterase
Current Alzheimer Research The Pleiotropic Effects of ARB in Vascular Endothelial Progenitor Cells
Current Vascular Pharmacology Macrovascular Complications of Type 2 Diabetes Mellitus
Current Vascular Pharmacology Modulation of Cardiovascular Remodeling with Statins: Fact or Fiction?
Current Vascular Pharmacology Transdermal Delivery of Captopril and Metoprolol Tartrate with Microneedles
Drug Delivery Letters Fibrates and Microvascular Complications in Diabetes - Insight from the FIELD Study
Current Pharmaceutical Design Editorial from Guest Editor: Current Management of Sleep Apnea and Comorbidities
Current Respiratory Medicine Reviews Reliability of Blood Pressure Patterns Defined by a Single 24-Hour Ambulatory Blood Pressure Monitoring: The Case of the Dipping/Non Dipping and Isolated Clinic Hypertension
Current Hypertension Reviews A Systematic Review of First Trimester Biochemical and Molecular Predictive Tests for Preeclampsia
Current Hypertension Reviews Catalyst Free and Energy Economical Synthesis of Thiazole Derivatives Bearing Azo Imine Linkage with Imidazole as Antimicrobial Agents
Letters in Drug Design & Discovery The Role of Flow-Independent Exhaled Nitric Oxide Parameters in the Assessment of Airway Diseases
Current Topics in Medicinal Chemistry Angiotensin II Receptor Blocker as an Inverse Agonist: A Current Perspective
Current Hypertension Reviews