Kamiya Chiaki, Odagiri Keiichi, Hakamata Akio, Inui Naoki, Watanabe Hiroshi
Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine Hamamatsu Japan.
Circ Rep. 2019 Aug 28;1(9):389-395. doi: 10.1253/circrep.CR-19-0059.
Recent progress in the development of pulmonary hypertension (PH)-specific pharmaceutical agents has improved mortality and morbidity remarkably. Today, these PH-specific drugs have become a standard treatment for PH. We herein summarize the treatment options and longitudinal clinical outcomes of 21 patients with PH who received PH-specific drugs at the present institution. Sixteen patients began treatment with a single PH-specific drug; 9 of them needed additional PH-specific drugs, but the other 7 were still taking the same drug at the last follow-up. Five patients began treatment with a combination of 2 or 3 PH-specific drugs, and their drugs were not discontinued. Most patients (17/21) were taking a phosphodiesterase type 5 (PDE5) inhibitor at the last follow-up. During the 6.5±4.4 years' follow-up, 5 patients died, but only 1 death was related to PH. At 5 and 10 years, the estimated PH-related death-free and lung transplantation-free survival rate was 100% (95% CI: 100-100%) and 87.5% (95% CI: 38.7-98.1%), respectively. The estimated 5- and 10-year estimated overall survival rates were 77.9% (95% CI: 50.8-91.3%) and 68.2% (95% CI: 37.4-86.2%), respectively. PDE5 inhibitors played a central role in the treatment options. The long-term prognosis of PH was favorable at the present institution.
肺动脉高压(PH)特异性药物研发方面的最新进展显著改善了死亡率和发病率。如今,这些PH特异性药物已成为PH的标准治疗方法。我们在此总结了本机构中21例接受PH特异性药物治疗的PH患者的治疗选择和长期临床结果。16例患者开始使用单一PH特异性药物治疗;其中9例需要额外的PH特异性药物,但其他7例在最后一次随访时仍在服用同一种药物。5例患者开始使用2种或3种PH特异性药物联合治疗,且未停用药物。大多数患者(17/21)在最后一次随访时正在服用5型磷酸二酯酶(PDE5)抑制剂。在6.5±4.4年的随访期间,5例患者死亡,但只有1例死亡与PH相关。在5年和10年时,估计的无PH相关死亡和无肺移植生存率分别为100%(95%CI:100-100%)和87.5%(95%CI:38.7-98.1%)。估计的5年和10年总生存率分别为77.9%(95%CI:50.8-91.3%)和68.2%(95%CI:37.4-86.2%)。PDE5抑制剂在治疗选择中发挥了核心作用。在本机构中,PH的长期预后良好。