Karelkina E V, Goncharova N S, Simakova M A, Moiseeva O M
Almazov National medical research Centre.
Kardiologiia. 2020 Mar 30;60(4):36-42. doi: 10.18087/cardio.2020.4.n1026.
Aim To present an own experience in using a medication selexipag in patients with pulmonary arterial hypertension (PAH) included into the V. A. Almazov National Medical Research Center registry and participating in the GRIPHON and GRIPHON OL clinical studies.Material and methods 26 patients with PAH were included into this study since 2010: 20 patients with idiopathic PAH, 4 patients with PAH associated with systemic scleroderma, and 2 patients with corrected congenital heart defects. At the time of randomization, 19 patients had been receiving therapy with phosphodiesterase type 5 inhibitors for at least one month. Among the patients treated with selexipag (n=14), 4 patients reached a high individual maintenance dose (1200-1600 µg b.i.d.), 4 patients reached a medium dose (600-1000 µg b.i.d.), and 6 patients reached a low dose (200-400 µg b.i.d.).Results The selexipag therapy exerted a positive effect on secondary endpoints, specifically, on changes in the functional class of pulmonary hypertension, serum concentration of NT-proBNP, and physical working capacity of patients. Adverse events associated with the selexipag treatment, which resulted in termination of study participation, were observed in one patient.Conclusion To achieve the main goal of drug therapy, low risk of death with selexipag it is critical to observe the titration schedule and to aim at reaching the highest individual maintenance dose.
目的 介绍在纳入弗拉基米尔·阿拉佐夫国家医学研究中心登记处并参与GRIPHON和GRIPHON OL临床研究的肺动脉高压(PAH)患者中使用司来帕格药物的自身经验。
材料与方法 自2010年起,26例PAH患者纳入本研究:20例特发性PAH患者,4例与系统性硬化症相关的PAH患者,以及2例先天性心脏病矫正患者。随机分组时,19例患者已接受5型磷酸二酯酶抑制剂治疗至少1个月。在接受司来帕格治疗的患者(n = 14)中,4例患者达到高个体维持剂量(1200 - 1600 μg,每日两次),4例患者达到中等剂量(600 - 1000 μg,每日两次),6例患者达到低剂量(200 - 400 μg,每日两次)。
结果 司来帕格治疗对次要终点产生了积极影响,具体而言,对肺动脉高压功能分级、NT - proBNP血清浓度以及患者的体力工作能力的变化产生了积极影响。在1例患者中观察到与司来帕格治疗相关的不良事件,导致其终止参与研究。
结论 为实现药物治疗的主要目标,即使用司来帕格降低死亡风险,严格遵守滴定方案并旨在达到最高个体维持剂量至关重要。