What is the role of advanced vasodilatory therapies in the treatment of pulmonary arterial hypertension (PAH)?

Updated: Apr 25, 2018
  • Author: Kristin E Schwab, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

In contrast, advanced vasodilatory therapies are largely confined to cases of PAH. Guidelines recommend against using these advanced therapies in cases of pulmonary hypertension from left-sided heart disease or pulmonary disease, and initiation of these should be in specialized centers and by providers well experienced in treating PAH. [24] Since the WHO group 1 classification, multiple advanced vasoactive therapies have become available to treat the prostacyclin, endothelin, and nitric oxide/cyclic guanosine monophosphate (cGMP) pathways. Research is ongoing with new medications continually in the pipeline, with the hope that these new therapies may halt or reverse disease progression. [25]

The CHEST guideline, based on reviews of English-language literature published between 1990 and 2013 using the MedLine and the Cochrane databases, concluded that current pharmacotherapy for PAH should be based on high-level recommendations, but further study is needed to address gaps in such evidence-based information. [26]


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