Escalating Oral Treprostinil Dose With Intravenous Treprostinil Bridging Therapy.

Area of Science:

• Cardiology
• Pharmacology

Background:

• Oral treprostinil is a treatment for pulmonary arterial hypertension (PAH).
• Patients face challenges in reaching effective doses due to adverse effects.
• Optimizing oral treprostinil dosage is crucial for managing PAH progression.

Observation:

• A 47-year-old female patient with PAH experienced worsening symptoms despite outpatient oral treprostinil therapy.
• The patient had previously been successfully uptitrated on oral treprostinil, maintaining stability for years.
• Worsening symptoms necessitated a higher dosage, prompting a new treatment approach.

Findings:

• The patient was transitioned to a regimen involving intravenous therapy to facilitate dose escalation.
• Following bridging with intravenous therapy, the oral treprostinil dose was gradually increased to a new goal.
• This dose optimization resulted in significant improvements in the patient's symptoms and right ventricular function.

Implications:

• This case demonstrates the successful use of intravenous therapy as a bridge for optimizing oral treprostinil dosing in PAH.
• The findings highlight the versatility of oral treprostinil and the importance of individualized dose adjustments.
• Rapid dose escalation via bridging therapy can effectively manage PAH and improve patient outcomes.