Effects Of Inhaled Aviptadil (Vasoactive Intestinal Peptide) In Patients With Pulmonary Arterial Hypertension (PAH)

Galiè, Nazzareno; Boonstra, Anco; Ewert, Ralf; Gómez-Sánchez, Miguel Ángel; Barberà, Joan Albert; Torbicki, Adam; Bremer, Hinrich; Ghofrani, Ardeschir; Naeije, Robert; Gruenig, Ekkehard; Leuchte, Hanno; Simonneau, Gérald; Klose, Hans; Peacock, Andrew J.; Wilkens, Heinrike; Bevec, Dorian; Cavalli, Vera Lúcia de Liz Oliveira; Bacher, Gerald; Rubin, Lewis J.

doi:10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a2516

Cited by 20 publications

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“…28 Unfortunately, these promising findings have not been replicated. A more recent preliminary report showed no hemodynamic benefit in a cohort of subjects with PAH, 29 curbing enthusiasm for the drug.…”

Section: Other Possible Inhaled Therapies For Pulmonary Hypertension mentioning

confidence: 99%

Inhaled Therapies for Pulmonary Hypertension

2015

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The inhaled route has a number of attractive features for treatment of pulmonary hypertension, including delivery of drug directly to the target organ, thus enhancing pulmonary specificity and reducing systemic adverse effects. It can also improve ventilation/perfusion matching by dilating vessels supplying ventilated regions, thus improving gas exchange. Furthermore, it can achieve higher local drug concentrations at a lower overall dose, potentially reducing drug cost. Accordingly, a number of inhaled agents have been developed to treat pulmonary hypertension. Most in current use are prostacyclins, including epoprostenol, which has been cleared for intravenous applications but is used off-label in acute care settings as a continuously nebulized medication. Aerosolized iloprost and treprostinil are both prostacyclins that have been cleared by the FDA to treat pulmonary arterial hypertension (PAH). Both require frequent administration (6 and 4 times daily, respectively), and both have a tendency to cause airway symptoms, including cough and wheeze, which can lead to intolerance. These agents cannot be used to substitute for the infused routes of prostacyclin because they do not permit delivery of medication at high doses. Inhaled nitric oxide (INO) is cleared for the treatment of primary pulmonary hypertension in newborns. It is also used off-label to test acute vasoreactivity in PAH during right-heart catheterization and to treat acute right-heart failure in hospitalized patients. In addition, some studies on long-term application of INO either have been recently completed with results pending or are under consideration. In the future, because of its inherent advantages in targeting the lung, the inhaled route is likely to be tested using a variety of small molecules that show promise as PAH therapies. Key words: inhaled route; aerosol therapies; pulmonary hypertension; pulmonary arterial hypertension; inhaled nitric oxide. [Respir Care 2015;60(6):794 -805. © 2015 Daedalus Enterprises] 794RESPIRATORY CARE • JUNE 2015 VOL 60 NO 6

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Section: Other Possible Inhaled Therapies For Pulmonary Hypertension mentioning

confidence: 99%

Inhaled Therapies for Pulmonary Hypertension

2015

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“…Despite initial reports of hemodynamic and functional improvements in small uncontrolled studies, 114 a phase II RCT of inhaled vasoactive intestinal peptide in 56 PAH patients was unable to demonstrate any beneficial effects both in hemodynamics or exercise capacity. 115 No further trials of vasoactive intestinal peptide in PAH are currently ongoing.…”

Section: Vasoactive Intestinal Peptidementioning

confidence: 99%

Advances in Therapeutic Interventions for Patients With Pulmonary Arterial Hypertension

et al. 2014

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“…There was some early success in animal models but its promise has not been realised in humans and it has fallen by the wayside [ 187 ].…”

Section: Vasoactive Intestinal Peptidementioning

confidence: 99%

Current Treatment Strategies, Guidelines and New Therapies

Loveridge¹,

Bacon²,

Madden³

2015

Treatment of Pulmonary Hypertension

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Historically, primary pulmonary hypertension (as it was then termed) has been considered a rapidly progressive, fatal condition with no effective therapies with an average life expectancy of less than 3 years at diagnosis [ 1 ]. It has been labelled as a "desperate disease" and upon diagnosis one enters "the kingdom of the near-dead" [ 2 ].In the 1980s, the vasodilatation caused by high dose calcium channel blockers was discovered to have a beneficial effect. These results were shown to improve pulmonary artery pressure, pulmonary vascular resistance, right ventricular hypertrophy and survival. It did however become quickly apparent that the treated population could be clearly sub-divided into two categories -those who responded and those who did not [ 3 ].

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Effects Of Inhaled Aviptadil (Vasoactive Intestinal Peptide) In Patients With Pulmonary Arterial Hypertension (PAH)

Cited by 20 publications

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Inhaled Therapies for Pulmonary Hypertension

Inhaled Therapies for Pulmonary Hypertension

Advances in Therapeutic Interventions for Patients With Pulmonary Arterial Hypertension

Current Treatment Strategies, Guidelines and New Therapies

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