Details

Autor(en) / Beteiligte

• Frantz, Robert P., MD
• Schilz, Robert J., DO, PhD, FCCP
• Chakinala, Murali M., MD, FCCP
• Badesch, David B., MD, FCCP
• Frost, Adaani E., MD, FCCP
• McLaughlin, Vallerie V., MD, FCCP
• Barst, Robyn J., MD
• Rosenberg, Daniel M., PhD
• Miller, Dave P., MS
• Hartline, Brian K., MD
• Benton, Wade W., PharmD
• Farber, Harrison W., MD, FCCP

Titel

Hospitalization and Survival in Patients Using Epoprostenol for Injection in the PROSPECT Observational Study

Ist Teil von

• Chest, 2015-02, Vol.147 (2), p.484-494

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2015

Quelle

MEDLINE

Beschreibungen/Notizen

• BACKGROUND Few studies have prospectively reported outcomes in patients with pulmonary arterial hypertension (PAH) treated with epoprostenol in the modern-day era of oral therapy and combination treatments. The Registry to Prospectively Describe Use of Epoprostenol for Injection (Veletri, prolonged room temperature stable-epoprostenol [RTS-Epo]) in Patients with Pulmonary Arterial Hypertension (PROSPECT) was established to prospectively describe the course of PAH in patients prescribed RTS-Epo. METHODS PROSPECT is a multicenter, US-based drug registry of primarily group 1 patients with PAH treated with RTS-Epo who were parenteral-naive or parenteral-transitioned at enrollment. Patients were followed until discontinuation of RTS-Epo, withdrawal, loss to follow-up, death, or end of study (maximum 1 year). One-year freedom from hospitalization (FH) and survival estimates were summarized by prostacyclin history (parenteral-naive or parenteral-transitioned), sex, and chronic renal insufficiency (CRI). RESULTS A total of 336 patients were included. The overall 1-year FH estimate was 51.0% ! 2.8% and was lower in parenteral-naive patients than parenteral-transitioned patients (42.8% ! 4.3% vs 57.1% ! 3.7%, respectively; P = .002). FH estimates were lower in male patients than female patients (38.3% ! 5.9% vs 54.6% ! 3.2%, respectively; P < .015) and in patients with CRI than patients without CRI (17.0% ! 8.4% vs 53.7% ! 2.9%, respectively; P < .001). The overall 1-year survival estimate was 84.0% ! 2.1%. Survival was poorer in parenteral-naive patients, male patients, and patients with CRI. CONCLUSIONS Risk of hospitalization and mortality remain high in patients with PAH. In particular, patients who are parenteral-naive at initiation of RTS-Epo therapy, male patients, and patients with CRI require close monitoring and aggressive clinical management.