June 2024 PVRI Community Call with Julien Grynblat, David Montani and Stravros Zanos

Hypopituitarism has been reported in patients receiving continuous infusions of prostaglandin I2 (PGI2) analogues for pulmonary hypertension (PH). However, these patients' clinical characteristics, treatment, and prognoses remain unclear. This retrospective multicentre study included 22 patients who developed hypopituitarism while on continuous PGI2 analogue infusion between 1999 and 2021.

First approved by the US Food and Drug Administration in 2004, inhaled iloprost has become a mainstay of therapy for adults with pulmonary arterial hypertension (PAH) based on strong clinical trial evidence of its ability to improve symptoms and exercise capacity [1-3]. In 2023, however, the I-neb adaptive aerosol delivery system was discontinued, thereby limiting the availability of inhaled iloprost for new patients and promoting the ultimate discontinuation of the nebulized solution.

Pulmonary arterial hypertension (PAH) Group 1 from the World Health Organization (WHO) is a rare, severe chronic, and progressive condition. Patients with PAH have increased oxidative stress (OS) and diminished antioxidant capacity. Melatonin is a potent antioxidant hormone with reported benefits in PAH animal models.