Riociguat in the Treatment of Chronic Thromboembolic Pulmonary Hypertension: An Evidence-Based Review of Its Place in Therapy.

Core Evidence Pub Date : 2020-08-25 eCollection Date: 2020-01-01 DOI:10.2147/CE.S172791

Sahai Donaldson, Richard Ogunti, Angesom Kibreab, Alem Mehari

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引用次数: 6

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is classified as group-4 pulmonary hypertension caused by organized thrombi in pulmonary arteries and vasculopathy in nonoccluded areas leading to right heart failure and death. In addition to chronic anticoagulation therapy, each patient with CTEPH should receive treatment assessment starting with evaluation for pulmonary endarterectomy (PEA), which is the guideline recommended treatment. There is increasing experience with balloon pulmonary angioplasty (BPA) for inoperable patients; this option, like PEA, is reserved for specialized centers with expertise in this treatment method. Inoperable patients are candidates for targeted drug therapy. Riociguat remains the only approved medical therapy for CTEPH patients deemed inoperable or with persistent pulmonary hypertension after PEA. The role of riociguat therapy preoperatively or in tandem with BPA is currently under investigation. The purpose of this review is to evaluate the safety and efficacy of riociguat in the treatment of CTEPH.

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瑞西奎特治疗慢性血栓栓塞性肺动脉高压:循证评价其治疗地位。

慢性血栓栓塞性肺动脉高压(CTEPH)被归类为4组肺动脉高压，由肺动脉组织血栓和非闭塞区域血管病变引起，导致右心衰和死亡。除了慢性抗凝治疗外，每个CTEPH患者都应该接受治疗评估，首先评估肺动脉内膜切除术(PEA)，这是指南推荐的治疗方法。有越来越多的经验，球囊肺血管成形术(BPA)对不能手术的患者;与PEA一样，这种选择是为具有这种治疗方法专业知识的专业中心保留的。不能手术的病人是靶向药物治疗的候选者。Riociguat仍然是唯一被批准用于不能手术或PEA后持续肺动脉高压的CTEPH患者的药物治疗。目前正在研究术前或双酚a联用治疗的作用。本综述的目的是评价瑞西奎特治疗CTEPH的安全性和有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Core Evidence PHARMACOLOGY & PHARMACY-

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期刊介绍： Core Evidence evaluates the evidence underlying the potential place in therapy of drugs throughout their development lifecycle from preclinical to postlaunch. The focus of each review is to evaluate the case for a new drug or class in outcome terms in specific indications and patient groups The emerging evidence on new drugs is reviewed at key stages of development and evaluated against unmet needs