How a Most Unlikely Drug Changed the Outcome of Pulmonary Arterial Hypertension

ABSTRACT Epoprostenol is a prostaglandin that was first identified by investigators in 1976 and found to be a potent vasodilator and inhibiter of platelet aggregation, initially in animal studies and subsequently in humans. Based on these properties epoprostenol, which has a short half‐life of sever...

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Main Authors: Ivan M. Robbins, Anna R. Hemnes
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Pulmonary Circulation
Subjects:
Online Access:https://doi.org/10.1002/pul2.70059
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author Ivan M. Robbins
Anna R. Hemnes
author_facet Ivan M. Robbins
Anna R. Hemnes
author_sort Ivan M. Robbins
collection DOAJ
description ABSTRACT Epoprostenol is a prostaglandin that was first identified by investigators in 1976 and found to be a potent vasodilator and inhibiter of platelet aggregation, initially in animal studies and subsequently in humans. Based on these properties epoprostenol, which has a short half‐life of several minutes in vivo requiring continuous intravenous infusion, was administered to patients with pulmonary arterial hypertension (PAH) and found to decrease pulmonary vascular resistance (PVR) during acute vasodilator testing. Investigators then studied the effects of long‐term infusion of epoprostenol and observed sustained hemodynamic and clinical improvement, albeit with persistent elevation of pulmonary artery pressure and PVR. The results of a randomized multicenter study confirmed the benefit of epoprostenol, including improved survival, in patients with PAH leading to FDA approval in 1995. Before this, there was no effective therapy for the vast majority of patients with PAH. A number of other less complicated and safer medications have subsequently been approved for the treatment of patients with PAH. However, nearly 30 years after approval, despite the complexity and risks of continuous intravenous therapy, epoprostenol remains the most effective treatment for PAH.
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spelling doaj-art-eafd6a9708254cdfac58994dbf98d1212025-08-20T02:49:40ZengWileyPulmonary Circulation2045-89402025-01-01151n/an/a10.1002/pul2.70059How a Most Unlikely Drug Changed the Outcome of Pulmonary Arterial HypertensionIvan M. Robbins0Anna R. Hemnes1Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine Vanderbilt University Medical Center Nashville Tennessee USADivision of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine Vanderbilt University Medical Center Nashville Tennessee USAABSTRACT Epoprostenol is a prostaglandin that was first identified by investigators in 1976 and found to be a potent vasodilator and inhibiter of platelet aggregation, initially in animal studies and subsequently in humans. Based on these properties epoprostenol, which has a short half‐life of several minutes in vivo requiring continuous intravenous infusion, was administered to patients with pulmonary arterial hypertension (PAH) and found to decrease pulmonary vascular resistance (PVR) during acute vasodilator testing. Investigators then studied the effects of long‐term infusion of epoprostenol and observed sustained hemodynamic and clinical improvement, albeit with persistent elevation of pulmonary artery pressure and PVR. The results of a randomized multicenter study confirmed the benefit of epoprostenol, including improved survival, in patients with PAH leading to FDA approval in 1995. Before this, there was no effective therapy for the vast majority of patients with PAH. A number of other less complicated and safer medications have subsequently been approved for the treatment of patients with PAH. However, nearly 30 years after approval, despite the complexity and risks of continuous intravenous therapy, epoprostenol remains the most effective treatment for PAH.https://doi.org/10.1002/pul2.70059epoprostenolinfusionpulmonary hemodynamicstherapy
spellingShingle Ivan M. Robbins
Anna R. Hemnes
How a Most Unlikely Drug Changed the Outcome of Pulmonary Arterial Hypertension
Pulmonary Circulation
epoprostenol
infusion
pulmonary hemodynamics
therapy
title How a Most Unlikely Drug Changed the Outcome of Pulmonary Arterial Hypertension
title_full How a Most Unlikely Drug Changed the Outcome of Pulmonary Arterial Hypertension
title_fullStr How a Most Unlikely Drug Changed the Outcome of Pulmonary Arterial Hypertension
title_full_unstemmed How a Most Unlikely Drug Changed the Outcome of Pulmonary Arterial Hypertension
title_short How a Most Unlikely Drug Changed the Outcome of Pulmonary Arterial Hypertension
title_sort how a most unlikely drug changed the outcome of pulmonary arterial hypertension
topic epoprostenol
infusion
pulmonary hemodynamics
therapy
url https://doi.org/10.1002/pul2.70059
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