Treprostinil for the treatment of pulmonary arterial hypertension

Abstract

Pulmonary arterial hypertension (PAH) is a progressive and fatal disease characterized by increasing pulmonary vascular resistance leading to right ventricular failure and death. Treprostinil is a stable prostacyclin analog approved for the treatment of PAH to improve exercise capacity. In the setting of PAH, the major pharmacological actions of treprostinil include vasodilatation of the pulmonary and systemic vascular beds, inhibition of platelet aggregation and inhibition of smooth muscle cell proliferation. Treprostinil therapy may be delivered via parenteral (subcutaneous and intravenous) or inhaled routes of administration, with oral tablets in the later stages of clinical development. In clinical trials, treprostinil has been shown to improve clinical status, functional class, exercise capacity and quality of life. Common side effects of treprostinil therapy include headache, flushing, jaw pain, diarrhea, and for subcutaneous administration, infusion site pain or reaction. This article provides an overview of treprostinil therapy for the treatment of PAH with a focus on the available efficacy and safety data for parenteral, inhaled and oral administration.

Keywords::

• prostacyclin
• prostacyclin analog
• prostaglandin
• pulmonary arterial hypertension
• treprostinil

Financial & competing interests disclosure

Clinical trials for treprostinil were funded by the United Therapeutics Corporation. The authors have served as Consultants and Investigators for United Therapeutics. LJ Rubin serves on the Scientific Advisory Board of United Therapeutics. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing assistance was utilized in the production of this manuscript. The authors acknowledge Brooke Harrison and Strategic Pharma Solutions, Limited Liability Company, for their assistance in the preparation of this manuscript with support by United Therapeutics Corporation.