RESUMEN
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Asunto(s)
Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Fibrosis Pulmonar/etiología , Neoplasias Pulmonares/complicaciones , Factores de Riesgo , Enfermedades Pulmonares Intersticiales/patología , Enfisema Pulmonar/complicaciones , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/radioterapia , Tórax/patología , Tomografía Computarizada de EmisiónRESUMEN
BACKGROUND: Macitentan is the latest endothelin-receptor antagonist (ERA) approved for the treatment of pulmonary arterial hypertension (PAH), presenting enhanced properties over previous ERAs. OBJECTIVE: We describe the clinical and echocardiographic evolution of patients with PAH who started macitentan after discontinuing bosentan/ambrisentan. METHODS: This was a retrospective series of patients with different etiologies who started macitentan after the suspension of other ERAs under routine clinical practice at five Spanish hospitals. World Health Organization functional class (WHO-FC), 6-min walk distance (6MWD), levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and cardiac imaging data were collected and described at baseline (before macitentan initiation) and after 3, 6, and 12 months, when available. RESULTS: In total, 12 patients (ten women; mean age 65.63 ± 13.27 years) were observed. At baseline, most patients were receiving concomitant PAH medications, and five patients were classed as WHO-FC III. After 3 months of macitentan treatment, WHO-FC had improved in four patients, 6MWD increased in eight patients, and NT-proBNP levels and right atrial area were lowered in seven and eight patients, respectively. Similar results were observed after 6 and 12 months. Macitentan was well-tolerated, with no PAH hospitalizations, septostomies, transplants, or deaths registered. CONCLUSIONS: Our results suggest that switching to macitentan in patients with PAH who discontinued bosentan/ambrisentan was well-tolerated and effective. Further studies are needed to confirm these observations.
Asunto(s)
Antagonistas de los Receptores de Endotelina , Hipertensión Arterial Pulmonar , Pirimidinas , Sulfonamidas , Anciano , Ecocardiografía/métodos , Antagonistas de los Receptores de Endotelina/administración & dosificación , Antagonistas de los Receptores de Endotelina/efectos adversos , Femenino , Humanos , Masculino , Péptido Natriurético Encefálico/sangre , Fragmentos de Péptidos/sangre , Hipertensión Arterial Pulmonar/sangre , Hipertensión Arterial Pulmonar/diagnóstico , Hipertensión Arterial Pulmonar/tratamiento farmacológico , Hipertensión Arterial Pulmonar/fisiopatología , Pirimidinas/administración & dosificación , Pirimidinas/efectos adversos , Estudios Retrospectivos , España/epidemiología , Sulfonamidas/administración & dosificación , Sulfonamidas/efectos adversos , Resultado del Tratamiento , Prueba de Paso/métodos , Prueba de Paso/estadística & datos numéricosRESUMEN
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