Survival and drug persistence in patients receiving inhaled treprostinil at doses greater than 54 µg (nine breaths) four times daily.

Autor: Shapiro S; Division of Pulmonary Critical Care - VAGLAHS, Cardiology Section - UCLA David Geffen School of Medicine., Mandras S; Advent Health, Orlando, FL, USA., Restrepo-Jaramillo R; Division of Pulmonary, Critical Care & Sleep Medicine, University of South Florida, Tampa, FL, USA., Shen E; United Therapeutics Corporation, Research Triangle Park, NC, USA., Broderick M; United Therapeutics Corporation, Research Triangle Park, NC, USA., Rao Y; United Therapeutics Corporation, Research Triangle Park, NC, USA., Lee D; United Therapeutics Corporation, Research Triangle Park, NC, USA., Nelsen AC; United Therapeutics Corporation, Research Triangle Park, NC, USA.
Jazyk: angličtina
Zdroj: Pulmonary circulation [Pulm Circ] 2021 Oct 29; Vol. 11 (4), pp. 20458940211052228. Date of Electronic Publication: 2021 Oct 29 (Print Publication: 2021).
DOI: 10.1177/20458940211052228
Abstrakt: Treprostinil is a prostacyclin approved for the treatment of pulmonary arterial hypertension. Commercial data sets indicate that approximately 20-25% of patients are prescribed a higher dose than the maximum recommended dosage of nine breaths per treatment session (bps) (54 μg), four times a day (QID) and numerous studies have demonstrated the safety of doses >9 bps QID. This phase 4, retrospective analysis of specialty pharmacy records assessed the effects of inhaled treprostinil at doses >9 bps QID. Patients receiving inhaled treprostinil between September 2009 and June 2018 were included, and a random sampling of 5000 patients was selected for further analysis. Subjects were grouped based on the highest dose reached for ≥2 months within a rolling six-month window and were followed for up to three years. Of the total of 5000 patients analyzed, 28.5% received >9 bps QID. Survival rates were significantly higher in the >9 bps QID dosing group for years one, two, and three ( P  < 0.001). The time to transition to parenteral therapy was significantly longer for those at doses >9 bps (17.5 months) compared to doses ≤9 bps (9.5 moths; P  < 0.0001). Drug persistence was also significantly higher for those taking >9 bps at years 1, 2, and 3 ( P  < 0.0001). Patients receiving inhaled treprostinil at doses >9 bps QID had a higher rate of survival and drug persistence over a three-year period, suggesting that higher doses may provide clinically relevant benefits while remaining tolerable.
(© The Author(s) 2021.)
Databáze: MEDLINE
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