Inpatient Transition From Intravenous to Inhaled Treprostinil in a Pediatric Patient

Area of Science:

• Pediatric Cardiology
• Pulmonology
• Pharmacology

Background:

• Idiopathic pulmonary arterial hypertension (IPAH) is a rare and severe condition.
• Intravenous (IV) prostacyclin analogs are a common treatment for IPAH.
• Transitioning patients to alternative delivery methods requires careful management.

Purpose of the Study:

• To describe a successful transition from IV to inhaled treprostinil in a pediatric IPAH patient.
• To evaluate the safety and efficacy of inhaled treprostinil during this transition.
• To assess the patient's clinical status post-transition.

Main Methods:

• A 7-year-old male with IPAH underwent transition from IV treprostinil to inhaled treprostinil.
• The transition occurred during inpatient admission following removal of central venous catheters.
• Clinical, echocardiographic, and biomarker assessments were performed during and after the transition.

Main Results:

• The 4-day transition was completed without clinical, echocardiographic, or biomarker evidence of IPAH worsening.
• The patient was discharged home without complications.
• Three weeks post-discharge, pulmonary hypertension remained well-controlled, with improved 6-minute walk distance.

Conclusions:

• Inhaled treprostinil can be a safe and effective alternative to IV administration in select pediatric IPAH patients.
• Successful transition is feasible even after removal of central venous access.
• This approach may offer improved quality of life and reduced treatment burden.