Antiplatelet Effects of Prostacyclin Analogues: Which One to Choose in Case of Thrombosis or Bleeding?

Overview

Journal Cardiol J

Specialty Cardiology & Vascular Diseases

Date 2020 Nov 17

PMID 33200814

Citations 1

Authors

Sylwester P Rogula

Hubert M Mutwil

Aleksandra Gasecka

Marcin Kurzyna

Krzysztof J Filipiak

Affiliations

Soon will be listed here.

Abstract

Prostacyclin and analogues are successfully used in the treatment of pulmonary arterial hypertension (PAH) due to their vasodilatory effect on pulmonary arteries. Besides vasodilatory effect, prostacyclin analogues inhibit platelets, but their antiplatelet effect is not thoroughly established. The antiplatelet effect of prostacyclin analogues may be beneficial in case of increased risk of thromboembolic events, or undesirable in case of increased risk of bleeding. Since prostacyclin and analogues differ regarding their potency and form of administration, they might also inhibit platelets to a different extent. This review summarizes the recent evidence on the antiplatelet effects of prostacyclin and analogue in the treatment of PAH, this is important to consider when choosing the optimal treatment regimen in tailoring to an individual patients' needs.

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References

Simonneau G, Barst R, Galie N, Naeije R, Rich S, Bourge R . Continuous subcutaneous infusion of treprostinil, a prostacyclin analogue, in patients with pulmonary arterial hypertension: a double-blind, randomized, placebo-controlled trial. Am J Respir Crit Care Med. 2002; 165(6):800-4. DOI: 10.1164/ajrccm.165.6.2106079. View

Mindus S, Pawlowski J, Nisell M, Ferrara G . Intra-abdominal bleeding during treprostinil infusion in a patient with pulmonary arterial hypertension. BMJ Case Rep. 2013; 2013. PMC: 3604280. DOI: 10.1136/bcr-2013-008677. View

Lasne D, Jude B, Susen S . From normal to pathological hemostasis. Can J Anaesth. 2006; 53(6 Suppl):S2-11. DOI: 10.1007/BF03022247. View

Eifinger F, Sreeram N, Mehler K, Huenseler C, Kribs A, Roth B . Aerosolized iloprost in the treatment of pulmonary hypertension in extremely preterm infants: a pilot study. Klin Padiatr. 2007; 220(2):66-9. DOI: 10.1055/s-2007-984370. View

Barst R, Rubin L, Long W, McGoon M, Rich S, Badesch D . A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension. N Engl J Med. 1996; 334(5):296-301. DOI: 10.1056/NEJM199602013340504. View

de Donato G, Gussoni G, De Donato G, Andreozzi G, Bonizzoni E, Mazzone A . The ILAILL study: iloprost as adjuvant to surgery for acute ischemia of lower limbs: a randomized, placebo-controlled, double-blind study by the italian society for vascular and endovascular surgery. Ann Surg. 2006; 244(2):185-93. PMC: 1602150. DOI: 10.1097/01.sla.0000217555.49001.ca. View

Bettoni L, Geri A, Airo P, Danieli E, Cavazzana I, Antonioli C . Systemic sclerosis therapy with iloprost: a prospective observational study of 30 patients treated for a median of 3 years. Clin Rheumatol. 2002; 21(3):244-50. DOI: 10.1007/pl00011223. View

Kuwano K, Hashino A, Asaki T, Hamamoto T, Yamada T, Okubo K . 2-[4-[(5,6-diphenylpyrazin-2-yl)(isopropyl)amino]butoxy]-N-(methylsulfonyl)acetamide (NS-304), an orally available and long-acting prostacyclin receptor agonist prodrug. J Pharmacol Exp Ther. 2007; 322(3):1181-8. DOI: 10.1124/jpet.107.124248. View

Krause A, Machacek M, Lott D, Hurst N, Bruderer S, Dingemanse J . Population Modeling of Selexipag Pharmacokinetics and Clinical Response Parameters in Patients With Pulmonary Arterial Hypertension. CPT Pharmacometrics Syst Pharmacol. 2017; 6(7):477-485. PMC: 5529739. DOI: 10.1002/psp4.12202. View

10.

Safdar Z . Treatment of pulmonary arterial hypertension: the role of prostacyclin and prostaglandin analogs. Respir Med. 2011; 105(6):818-27. DOI: 10.1016/j.rmed.2010.12.018. View

11.

Barst R, Galie N, Naeije R, Simonneau G, Jeffs R, Arneson C . Long-term outcome in pulmonary arterial hypertension patients treated with subcutaneous treprostinil. Eur Respir J. 2006; 28(6):1195-203. DOI: 10.1183/09031936.06.00044406. View

12.

Melian E, Goa K . Beraprost: a review of its pharmacology and therapeutic efficacy in the treatment of peripheral arterial disease and pulmonary arterial hypertension. Drugs. 2002; 62(1):107-33. DOI: 10.2165/00003495-200262010-00005. View

13.

Bajwa A, Shujaat A, Patel M, Thomas C, Rahaghi F, Burger C . The safety and tolerability of inhaled treprostinil in patients with pulmonary hypertension and chronic obstructive pulmonary disease. Pulm Circ. 2017; 7(1):82-88. PMC: 5448530. DOI: 10.1086/689291. View

14.

Gomberg-Maitland M, Tapson V, Benza R, McLaughlin V, Krichman A, Widlitz A . Transition from intravenous epoprostenol to intravenous treprostinil in pulmonary hypertension. Am J Respir Crit Care Med. 2005; 172(12):1586-9. DOI: 10.1164/rccm.200505-766OC. View

15.

Kingman M, Archer-Chicko C, Bartlett M, Beckmann J, Hohsfield R, Lombardi S . Management of prostacyclin side effects in adult patients with pulmonary arterial hypertension. Pulm Circ. 2017; 7(3):598-608. PMC: 5841898. DOI: 10.1177/2045893217719250. View

16.

Mubarak K . A review of prostaglandin analogs in the management of patients with pulmonary arterial hypertension. Respir Med. 2009; 104(1):9-21. DOI: 10.1016/j.rmed.2009.07.015. View

17.

Whittle B, Silverstein A, Mottola D, Clapp L . Binding and activity of the prostacyclin receptor (IP) agonists, treprostinil and iloprost, at human prostanoid receptors: treprostinil is a potent DP1 and EP2 agonist. Biochem Pharmacol. 2012; 84(1):68-75. DOI: 10.1016/j.bcp.2012.03.012. View

18.

Boie Y, Sawyer N, Slipetz D, Metters K, Abramovitz M . Molecular cloning and characterization of the human prostanoid DP receptor. J Biol Chem. 1995; 270(32):18910-6. DOI: 10.1074/jbc.270.32.18910. View

19.

Sitbon O, Channick R, Chin K, Frey A, Gaine S, Galie N . Selexipag for the Treatment of Pulmonary Arterial Hypertension. N Engl J Med. 2015; 373(26):2522-33. DOI: 10.1056/NEJMoa1503184. View

20.

Louis L, Bair N, Banjac S, Dweik R, Tonelli A . Subdural hematomas in pulmonary arterial hypertension patients treated with prostacyclin analogs [corrected]. Pulm Circ. 2013; 2(4):518-21. PMC: 3555423. DOI: 10.4103/2045-8932.105041. View