What is the role of prostacyclin analogues and receptor agonists in the treatment of cor pulmonale?

Updated: Dec 15, 2017
  • Author: Derek Leong, MD; Chief Editor: Henry H Ooi, MD, MRCPI  more...
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Answer

Answer

Epoprostenol, treprostinil, and bosentan are prostacyclin (PGI2) analogues and have potent vasodilatory properties. [28] Epoprostenol is administered intravenously (IV). Treprostinil can be administered IV and subcutaneously (SC); the FDA has approved oral and inhaled formulations. Iloprost is commonly inhaled but requires frequent dosing.

Of these prostacyclin analogues, epoprostenol has been the most studied; it has been shown to improve survival in idiopathic pulmonary arterial hypertension as well as some benefit in other types of World Health Organization (WHO) classification group 1 pulmonary hypertension, particularly in patients with more severe functional status. [29]

Selexipag is a prostacyclin receptor agonist, which acts to vasodilate the pulmonary vasculature. It is administered orally and has been shown to reduce disease progression in PAH. [30]


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