Advances in prostanoid infusion therapy for pulmonary arterial hypertension

Pulmonary arterial hypertension is a rare but progressive and life-threatening disease that presents considerable challenges for both the patient and the caregiver. Though complex, intravenous epoprostenol and treprostinil may improve long-term survival, exercise capacity, hemodynamics, and other clinical symptoms of pulmonary arterial hypertension. Recent advances in infusion pump technology offer ambulatory pump sizes as small as a pager and continuous infusion flow rates as low as 0.1 mL/h, which may provide quality-of-life advantages for patients treated with treprostinil. Transition methods from epoprostenol to treprostinil vary and require close patient monitoring for up to several months. Patients and clinicians must be aware of the differences among delivery systems and the potential for adverse events.