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New Directions in Pulmonary Hypertension Therapy

  • Chapter
Pulmonary Hypertension

Part of the book series: Contemporary Cardiology™ ((CONCARD))

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Great progress in the understanding of the pathogenesis of as well as the therapy for pulmonary hypertension has been made in the last 20 years, but many challenges remain. Combinations of prostanoids, endothelin antagonists, and phosphodiesterase inhibitors are seeing increasing use, and clinical trials currently underway should identify which combinations work best. Nebulized treprostinil, selective endothelin-A antagonists, and newer phosphodiesterase inhibitors may offer advantages and expand our therapeutic armamentarium in the near future. Clinical trials of statins, SSRIs, VIP, potassium channel activators, or antiplatelets are also ongoing or are likely to commence in the near future. Agents that interrupt signaling pathways such as Rho kinases and tyrosine kinases also show promise. The biological plausibility, availability, and relative safety of these newer agents make it tempting to prescribe them now, particularly when faced with gravely ill patients. However, these and all future therapies require proof of efficacy and safety from properly conducted clinical trials before widespread use can be advocated. Too many patients are still severely limited by and dying of pulmonary arterial hypertension to warrant therapeutic complacency at this time. While we await proof of safety and efficacy, we must continue to enroll patients in clinical trials.

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Authors
  1. Christopher M. Carlin
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  2. Andrew J. Peacock
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Editors and Affiliations

  1. Division of Pulmonary, Critical Care and Sleep Medicine Tufts Medical Center, Boston, MA

    Nicholas S. Hill MD

  2. Pulmonary Center, Boston University, Boston, MA

    Harrison W. Farber MD

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Carlin, C.M., Peacock, A.J. (2008). New Directions in Pulmonary Hypertension Therapy. In: Hill, N.S., Farber, H.W. (eds) Pulmonary Hypertension. Contemporary Cardiology™. Humana Press. https://doi.org/10.1007/978-1-60327-075-5_19

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