Side Effects of treprostinil: A Synthesis of Findings from 27 Studies

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Original Abstract of the Article

Major Research Findings

Treprostinil is a medication widely used to treat pulmonary arterial hypertension (PAH). Many studies have shown that treprostinil improves exercise capacity and quality of life for PAH patients, and extends their survival time. However, treprostinil can cause side effects in some patients. These side effects include headaches, nausea, coughing, throat pain, and flushing. However, studies have shown that treprostinil is associated with fewer side effects and is safer to use than other prostaglandin analogs. 23 , 4 , 13 , 21 , 2 , 22 , 27 , 25 , 5 , 24 , 16 , 19 , 8 , 3 , 7 , 20 , 10 , 12 , 15 , 14 , 6 , 17 , 18 , 11 , 9 , 26

Reasons for side effects

Treprostinil is an analog of prostaglandin I2 (PGI2) and exhibits vasodilatory effects. This effect helps to dilate the pulmonary vessels of PAH patients and improve blood flow. However, treprostinil's vasodilatory effects can also affect other organs. For example, treprostinil can dilate blood vessels in the heart and brain, which can cause side effects such as headaches and nausea. Also, treprostinil can dilate the bronchi, which can cause side effects such as coughing and throat pain. 20 , 13 , 17

Common side effects

Headache

The most common side effect of treprostinil is headache. This is because treprostinil dilates blood vessels, increasing blood flow in the blood vessels of the brain. Headaches are usually mild to moderate and can often be relieved with painkillers. 21 , 2 , 22 , 5 , 19 , 6 , 26

Nausea

Another common side effect of treprostinil is nausea. This is because treprostinil dilates blood vessels in the digestive system, increasing blood flow in the digestive tract. Nausea is usually mild to moderate and can often be relieved with antiemetics. 2 , 5 , 19

Cough

Treprostinil can cause coughing. This is because treprostinil dilates the bronchi, making the airways more sensitive. Coughing is usually mild to moderate and can often be relieved with cough suppressants. 2 , 5 , 14 , 6

Throat pain

Treprostinil can cause throat pain. This is because treprostinil can irritate the airways. Throat pain is usually mild to moderate and can often be relieved with painkillers. 2 , 5 , 14 , 6

Flushing

Treprostinil can cause flushing. This is because treprostinil dilates blood vessels, increasing blood flow in the skin. Flushing is usually mild to moderate and can often be relieved with cold compresses. 2 , 5

Countermeasures for side effects

Headache

Headaches usually subside within a few weeks of starting treprostinil. If you have a severe headache, consult your doctor. Your doctor may prescribe pain relievers or other treatments. 21 , 2 , 22 , 5 , 19 , 6 , 26

Nausea

Nausea usually subsides within a few weeks of starting treprostinil. If you have severe nausea, consult your doctor. Your doctor may prescribe antiemetics or other treatments. 2 , 5 , 19

Cough

Coughing usually subsides within a few weeks of starting treprostinil. If you have a severe cough, consult your doctor. Your doctor may prescribe cough suppressants or other treatments. 2 , 5 , 14 , 6

Throat pain

Throat pain usually subsides within a few weeks of starting treprostinil. If you have severe throat pain, consult your doctor. Your doctor may prescribe painkillers or other treatments. 2 , 5 , 14 , 6

Flushing

Flushing usually subsides within a few weeks of starting treprostinil. If you have severe flushing, consult your doctor. Your doctor may prescribe cold compresses or other treatments. 2 , 5

Comparison between studies

Commonalities between studies

Many studies have shown that treprostinil improves exercise capacity and quality of life for PAH patients and extends their survival time. 2 , 5 , 21 , 22 , 19 , 27 , 25 , 6 , 24 , 16 , 8 , 3 , 7 , 20 , 10 , 12 , 15 , 14 , 23 , 4 , 17 , 18 , 11 , 9 , 26

Differences between studies

Side effects of treprostinil may vary from patient to patient. 9 , 26 , 13 , 20

Considerations for application in real life

Treprostinil is an important treatment for PAH patients. However, treprostinil can cause side effects. It is important to consult your doctor before using treprostinil and to be aware of the signs of side effects. 9 , 26 , 20 , 13

Limitations of current research

Research on the side effects of treprostinil is still not sufficient. In particular, research on the side effects of long-term use of treprostinil is lacking. Therefore, there are still many unknowns about the side effects of long-term use of treprostinil. 9 , 26 , 13 , 20

Future research directions

Further research is needed to investigate the side effects of treprostinil in more detail. Research on the side effects of long-term use of treprostinil is particularly important. In addition, the development of new treatments to reduce the side effects of treprostinil is also needed. 9 , 26 , 13 , 20

Conclusion

Treprostinil is an important treatment for PAH patients. However, treprostinil can cause side effects. It is important to consult your doctor before using treprostinil and to be aware of the signs of side effects. 9 , 26 , 20 , 13

Literature analysis of 27 papers
Positive Content
25
Neutral Content
0
Negative Content
2
Article Type
0
0
0
5
26
2.

Plain language summary of the INCREASE study: inhaled treprostinil (Tyvaso) for the treatment of pulmonary hypertension due to interstitial lung disease.

Author: WestNatalie, SmootKaren, PatzlaffNatalie, MiceliMelissa, WaxmanAaron

PH-ILD treatment

The INCREASE study found that inhaled treprostinil was effective and safe in adults with pulmonary hypertension associated with interstitial lung disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Inhaled iloprost as an add-on therapy for advanced pulmonary arterial hypertension: An Indian perspective.

Author: BobhatePrashant, GuptaRajat Kumar, KarandeTanuja, KulkarniSnehal

PAH treatment

This study reports the benefits and difficulties of using inhaled iloprost in patients with advanced PAH in India, where prostacyclin analogues are not marketed. The study found that inhaled iloprost can be used with acceptable benefits and minimal side-effects in patients with PAH.

Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Subcutaneous use of treprostinil in pediatric pulmonary hypertension patients: A report of three cases.

Author: KavgacıAkif, KulaSerdar, İncedereFatma, TerlemezSemiha, TunaoğluFatma Sedef

Symptom relief

This article describes three pediatric cases of pulmonary arterial hypertension in whom subcutaneous treprostinil was used.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Pulmonary hypertension inhaled therapies: An updated review.

Author: El-KershKarim, JalilBilal A

Reduced side effects
Targeted delivery

This review article summarizes the evidence for the currently approved inhaled PAH/PH therapies, discusses the available inhalation devices, presents a roadmap for successful treatment strategy, and presents several inhaled PAH/PH therapies in the pipeline.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

6.

Efficacy, safety, and pharmacokinetics of inhaled treprostinil in Japanese patients with pulmonary arterial hypertension.

Author: KuwanaMasataka, AbeKohtaro, KinoshitaHideyuki, MatsubaraHiromi, MinatsukiShun, MuroharaToyoaki, SakaoSeiichiro, ShiraiYuichiro, TaharaNobuhiro, TsujinoIchizo, TakahashiKenta, KandaShingo, OgoTakeshi

Exercise Capacity
Hemodynamics Improvement
PAH Treatment
Cough
Headache
Hot Flush
Throat Irritation

Inhaled treprostinil, a prostacyclin analog, showed significant improvements in hemodynamics, exercise capacity, and symptoms in Japanese patients with pulmonary arterial hypertension, with a favorable safety profile.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Quantifying side effects and caregiver burdens of pediatric pulmonary hypertension therapies.

Author: NelsonErik J, CookElla, NelsonSamara, BrownRebecca, PierceMegan, SeelosAshley Bangerter, StickleHeather, JohansenMichael

Family burden
Side effects

Pulmonary hypertension (PH) is a serious condition in children, but treatment therapies are often used "off label". This study aims to understand the side effect profiles of commonly used pediatric PH therapies and the burdens faced by families caring for children with PH.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Practical considerations in the management of inhaled prostacyclin therapy for pulmonary hypertension associated with interstitial lung disease (WHO group 3).

Author: LeeCharlie, HamlynJoan, PorcelliJulie, SchmitAnn

PH-ILD treatment efficacy
Inhaled prostacyclin side effects

Inhaled treprostinil (Tyvaso) has been approved for the treatment of pulmonary hypertension associated with interstitial lung disease (PH-ILD). This review provides practical considerations for optimizing the management of PH-ILD patients, including patient education, monitoring, titration methods, and mitigation of side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

An overview of the biology of a long-acting inhaled treprostinil prodrug.

Author: ChapmanRichard W, CorbozMichel R, MalininVladimir S, PlauntAdam J, KonicekDonna M, LiZhili, PerkinsWalter R

PAH treatment
Respiratory side effects

This report describes the discovery and preclinical development of treprostinil palmitil (TP), a long-acting prodrug of treprostinil (TRE), for the treatment of pulmonary arterial hypertension (PAH). TP, formulated as a nebulized inhaled suspension (TPIS), was shown to have a slower conversion rate to TRE than short-alkyl chain TRE prodrugs, providing a longer duration of action.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

Transition protocol from subcutaneous treprostinil to intravenous epoprostenol in deteriorating patients with pulmonary arterial hypertension.

Author: MouratoglouSophia Anastasia, PatsialaAnthoula, FeloukidisChristos, KarvounisHaralambos, GiannakoulasGeorge

PAH treatment
side effects

A transition protocol from subcutaneous treprostinil to intravenous epoprostenol does not exist, despite continuous parenteral prostanoid administration being the treatment of choice for patients with advanced pulmonary arterial hypertension.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Hemodynamic and clinical effects of selexipag in children with pulmonary hypertension.

Author: RothmanAbraham, CruzGabriel, EvansWilliam N, RestrepoHumberto

PAH treatment

Selexipag, an oral prostacyclin receptor agonist, was safe and well-tolerated in four pediatric patients with pulmonary hypertension over 16-28 months. One patient successfully transitioned from subcutaneous treprostinil to selexipag.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

Ambulatory Transition from Parenteral Prostanoid to Inhaled Treprostinil in Patients with Pulmonary Arterial Hypertension.

Author: KimmigLucas M, LiaoChuanhong, BagRemzi

PAH treatment

Transitioning from intravenous or subcutaneous prostanoid drugs to inhaled treprostinil in clinically stable patients with pulmonary arterial hypertension is a viable option. Further research is needed to determine the optimal setting for transition.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Titration of pulmonary arterial hypertension therapeutics: Experience-based recommendations.

Author: LombardiSandra, KingmanMartha, DuncanMaribeth, BerngardSamuel Clark, FernandesTimothy

Exercise capacity
Quality of life
Time to clinical worsening
Adherence challenges
Catheter-related infections
Infusion site pain

This article provides recommendations for dose titration schemes for pulmonary arterial hypertension (PAH) medications that require individualized dosing in adult patients. It emphasizes the importance of careful titration to maximize therapeutic effectiveness while minimizing side effects, considering different routes of administration and potential challenges they present. The article stresses the critical role of patient education, frequent monitoring, and treatment adherence for optimal outcomes.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

24.

Treprostinil Improves Persistent Pulmonary Hypertension Associated with Congenital Diaphragmatic Hernia.

Author: LawrenceKendall M, HedrickHolly L, MonkHeather M, HerkertLisa, WaqarLindsay N, HannaBrian D, PeranteauWilliam H, RintoulNatalie E, HopperRachel K

Pulmonary hypertension treatment
Treprostinil safety
High mortality

Treprostinil improved pulmonary hypertension severity in infants with congenital diaphragmatic hernia, as measured by echocardiogram and BNP levels, without causing significant side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

25.

Safety, efficacy and Management of subcutaneous treprostinil infusions in the treatment of severe pediatric pulmonary hypertension.

Author: LevyMarilyne, Del CerroMaria-Jesus, NadaudSophie, VadlamudiKarunakar, ColgazierElizabeth, FinemanJeff, BonnetDamien, AdatiaIan

Pulmonary arterial hypertension treatment
Subcutaneous treprostinil

Subcutaneous treprostinil is a safe and effective treatment for pulmonary arterial hypertension in children, offering a less invasive alternative to intravenous epoprostenol.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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