Division for Health Service Promotion, University of Tokyo, Tokyo, Japan.
J Cardiol. 2012 Nov;60(5):344-9. doi: 10.1016/j.jjcc.2012.08.009. Epub 2012 Oct 12.
Since the innovation of epoprostenol, a prostacyclin analog, providing treatment for pulmonary arterial hypertension (PAH) in the 1990s, two types of oral drugs, endothelin receptor antagonists (ERAs) and phosphodiesterase V inhibitors, have further improved therapy for PAH. In contrast, it has become clear that the efficacy of monotherapy with these drugs is limited, and the establishment of combination therapies should be considered for PAH. Given that the newest PAH drugs include a receptor tyrosine kinase antagonist (imatinib), a soluble guanylate cyclase stimulator (riociguat), an oral analog of prostacyclin (selexipag), and a tissue targeting ERA (macitentan) determination of appropriate combinations for various etiologies and clinical stages is urgently required. In the next decade, it can be expected that the discovery of efficacious combination therapies, involving old and new drugs, will lead to significant advances in the treatment of PAH.
自 20 世纪 90 年代前列环素类似物依前列醇被创新用于治疗肺动脉高压（PAH）以来，两种口服药物，内皮素受体拮抗剂（ERA）和磷酸二酯酶 V 抑制剂，进一步改善了 PAH 的治疗效果。相比之下，这些药物单药治疗的疗效有限已变得明显，应考虑为 PAH 建立联合治疗方案。鉴于最新的 PAH 药物包括受体酪氨酸激酶拮抗剂（伊马替尼）、可溶性鸟苷酸环化酶刺激剂（利奥西呱）、前列环素的口服类似物（塞乐西帕）和组织靶向 ERA（马西替坦），迫切需要确定针对各种病因和临床阶段的合适组合。可以预计，在未来十年内，发现有效联合治疗方案，包括新旧药物，将推动 PAH 治疗的重大进展。
