Subcutaneous treprostinil is used as a continuous infusion treatment in terms of monotherapy or combination in pulmonary hypertension (PH) patients with advanced functional class (FC) for increasing the survival. Because of difficulties in practice the experience with this treatment is limited.
Material and Methods:
Six patients (five female, one male) who underwent subcutaneous treprostinil infusion therapy in the Pulmonary Hypertension clinic of Istanbul Medical Faculty between 2014-2018 were evaluated.
The mean age was 38 years and the mean follow-up period was 42.3 months (26-71 months). One patient had idiopathic pulmonary arterial hypertension (IPAH), one had Eisenmenger syndrome, three had PAH associated with systemic sclerosis and one had chronic thromboembolic pulmonary hypertension (CTEPH). Subcutaneous treprostinil was added as third drug in all patients. The mean duration of treatment was 13 months. Pre-treatment; PAPsystolic measured by echocardiography was 86 mmHg. PAPmean measured by right heart catheterization was 47 mmHg. FC was IV in three patients, and III in three cases. Six-minute walk (6MW) test could not perform in one of the patients because of severe dyspnea. Mean six-minute walk distance (6MWD) of the others was 235m. Mean Pro-BNP level was 1113 pg/ml. Post-treatment, PAPsystolic was 67 mmHg,6MWD was 336m, pro-BNP was 867pg/ml. FS was improved in five of them (only one patient had FC IV). All patients except one well tolerated this treatment. For the patient who had severe pain in the catheter site treatment was changed with iv epoprostenol.
Functional class and 6MWD improved and proBNP levels decreased with subcutaneous treprostinil treatment, in our patients with pulmonary hypertension.