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Биохимический путь оксида азота в терапии легочной артериальной гипертензии и результаты исследования RESPITE - Журнал Системные Гипертензии Том 15, №2
Биохимический путь оксида азота в терапии легочной артериальной гипертензии и результаты исследования RESPITE
Шмальц А.А., Горбачевский С.В. Биохимический путь оксида азота в терапии легочной артериальной гипертензии и результаты исследования RESPITE. Системные гипертензии. 2018; 15 (2): 72–76. DOI: 10.26442/2075-082X_2018.2.72-76
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Аннотация
Недостаточное содержание эндогенного оксида азота и циклического гуанозинмонофосфата (цГМФ) в стенке легочных сосудов играет важную роль в патогенезе легочной артериальной гипертензии (ЛАГ). Стимулятор растворимой гуанилатциклазы риоцигуат и ингибитор фосфодиэстеразы-5 (иФДЭ-5) силденафил увеличивают содержание цГМФ и имеют доказанную клиническую эффективность при ЛАГ. Потенциально выгодными особенностями механизма действия риоцигуата являются независимость от эндогенного оксида азота при синтезе цГМФ и независимость от других (помимо ФДЭ-5) изоферментов фосфодиэстераз. Клиническая возможность, безопасность и эффективность замены иФДЭ-5 на риоцигуат у больных ЛАГ впервые показана в неконтролируемом исследовании RESPITE и продолжает оцениваться в рандомизированном плацебо-контролируемом исследовании REPLACE.
Ключевые слова: легочная артериальная гипертензия, ЛАГ-специфическая терапия, стимуляторы растворимой гуанилатциклазы, ингибиторы фосфодиэстеразы-5, оксид азота.
Key words: pulmonary arterial hypertension, PAH-specific therapy, soluble guanylate cyclase stimulators, phosphodiesterase-5 inhibitors, nitrogen oxide.
Ключевые слова: легочная артериальная гипертензия, ЛАГ-специфическая терапия, стимуляторы растворимой гуанилатциклазы, ингибиторы фосфодиэстеразы-5, оксид азота.
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Key words: pulmonary arterial hypertension, PAH-specific therapy, soluble guanylate cyclase stimulators, phosphodiesterase-5 inhibitors, nitrogen oxide.
Полный текст
Список литературы
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44. Lichtblau M, Harzheim D, Ehlken N et al. Safety and long-term efficacy of transition from sildenafil to tadalafil due to side effects in patients with pulmonary arterial hypertension. Lung 2015; 193: 105–12.
45. Dos Santos Fernandes CJC, Humbert M, Souza R. Challenging the concept of adding more drugs in pulmonary arterial hypertension. Eur Respir J 2017; 50: 1701527 https://doi.org/10.1183/13993003.01527-2017.
2. Legochnaia gipertenziia. Rossiiskie klinicheskie rekomendatsii, 2016. http://cr.rosminzdrav.ru/schema.html?id=136#/text [in Russian]
3. Galiè N, Simonneau G. (eds). Updates in Pulmonary Hypertension Proceedings of the 5th World Symposium on Pulmonary Hypertension. J Am Coll Cardiol 2013; 62 (25; Suppl. D).
4. Galiè N, Humbert M, Vachiery JL et al. 2015ESC/ERSGuidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 2016; 37 (1).
5. Galiè N, Humbert M, Vachiery JL и соавт. Рекомендации ESC/ERS по диагностике и лечению легочной гипертензии. Рос. кардиол. журн. 2016; 5 (133): 5–64. / Galiè N, Humbert M, Vachiery JL i soavt. Rekomendatsii ESC/ERS po diagnostike i lecheniiu legochnoi gipertenzii. Ros. kardiol. zhurn. 2016; 5 (133): 5–64. [in Russian]
6. Hoeper MM, Simonneau G, Corris PA et al. RESPITE: switching to riociguat in pulmonaryarterialhypertensionpatients with inadequateresponse to phosphodiesterase-5inhibitors. Eur Respir J 2017; 50 (3): 1602425.
7. Madigan M, Zuckerbraun B. Therapeutic Potential of the Nitrite-Generated NO Pathway in Vascular Dysfunction. Front Immunol 2013; 4: 174.
8. Wilkins MR. Pulmonary hypertension: the science behind the disease spectrum. Eur Respir Rev 2012; 21 (123): 19–26.
9. O’Callaghan DS, Savale L, Montari D et al. Treatment of pulmonary arterial hypertension with targeted therapies. Nat Rev Cardiol 2011; 8: 526–38.
10. Ghofrani HA, Voswinckel R, Gall H et al. Riociguat for pulmonary hypertension. Future Cardiol 2010; 6: 155–66.
11. Stasch JP, Pacher P, Evgenov OV. Solubleguanylate cyclase as an emerging therapeutic target in cardiopulmonary disease. Circulation 2011; 123: 2263–73.
12. Ignarro LJ. NO More Heart Disease: How Nitric Oxide Can Prevent – Even Reverse – Heart Disease and Strokes. New York: St. Martin's Press; 2005.
13. Lundberg JO, Gladwin MT, Weitzberg E. Strategies to increasenitric oxidesignalling in cardiovascular disease. Nat Rev Drug Discov 2015; 14 (9): 623–41.
14. cGMP: Generators, Effectors and Therapeutic Implications. Ed. by: HH Schmidt, F Hofmann, JP Stasch. Handbook of Experimental Pharmacology 191. Springer-Verlag Berlin Heidelberg, 2009.
15. Stasch JP, Evgenov OV. Soluble Guanylate Cyclase Stimulators in Pulmonary Hypertension. In: Humbert et al. (eds.). Pharmacotherapy of Pulmonary Hypertension. Springer-Verlag Berlin Heidelberg, 2013; p. 279–313.
16. Cooper CJ, Landzberg MJ, Anderson TJ et al. Role of nitric oxide in the local regulation of pulmonary vascular resistance in humans. Circulation 1996; 93: 266 –71.
17. Koshland DE. The Molecule of the Year. Science 1992; 258: 1861.
18. Kielstein JT, Bode-Böger SM, Hesse G et al. Asymmetrical dimethylarginine in idiopathic pulmonary arterial hypertension. Arterioscler Thromb Vasc Biol 2005; 25 (7): 1414–8.
19. Giaid A, Saleh D. Reducedexpression of endothelial nitric oxide synthase in the lungs of patients with pulmonary hypertension. N Engl J Med 1995; 333 (4): 214–21.
20. Hemnes AR, Champion HC. Sildenafil, a PDE5 inhibitor, in the treatment of pulmonary hypertension. Exp Rev Cardiovasc Ther 2006; 4: 293–300.
21. Revatsio®. Instruktsiia po primeneniiu lekarstvennogo preparata dlia meditsinskogo primeneniia. LP-000197-13052014. http://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=59d051ad-f651-452e-acbd-aaae0b671b74&am... [in Russian]
22. Galiè N, Ghofrani HA, Torbicki A et al. Sildenafil citrate therapy for pulmonary arterial hypertension. New Engl J Med 2005; 353: 2148–2157.
23. Simonneau G, Rubin LJ, Galiè N al. Addition of sildenafil to long-term intravenous epoprostenol therapy in patients with pulmonary arterial hypertension:a randomized trial. Ann Intern Med 2008; 149: 521–30.
24. Sastry BK, Narasimhan C, Reddy NK, Raju BS. Clinical efficacy of sildenafil in primary pulmonary hypertension: a randomized, placebo-controlled, double-blind, crossover study. J Am Coll Cardiol 2004; 43 (7): 1149–53.
25. Singh TP, Rohit M, Grover A et al. A randomized, placebo-controlled, double-blind, crossover study to evaluate the efficacy of oralsildenafiltherapy in severepulmonary artery hypertension. Am Heart J 2006; 151 (4): 851.e1-5.
26. Guha M. First-in-class guanylate cyclase stimulator approved for PAH. Nat Biotechnol 2013; 31: 1064.
27. Pulido T, Adzerikho I, Channick RN et al. Macitentan and morbidity and mortalityin pulmonary arterial hypertension. N Engl J Med 2013; 369: 809–18.
28. Evgenov OV, Pacher P, Schmidt PM et al. NO-independentstimulators and activators of soluble guanylate cyclase: discovery and therapeuticpotential. Nat Rev Drug Discov 2006; 5 (9): 755–68.
29. Mittendorf J, Weigand S, Alonso-Alija C et al. Discovery of riociguat (BAY 63-2521): a potent, oral stimulator of soluble guanylate cyclase for the treatment of pulmonary hypertension. Chem Med Chem 2009; 4: 853–65.
30. Ghofrani HA, Galiè N, Grimminger F, Grünig E et al. Riociguat for the treatment of pulmonary arterial hypertension. N Engl J Med 2013; 369: 330–40.
31. Taran I.N., Martyniuk T.V., Nakonechnikov S.N., Chazova I.E. Innovatsiia v medikamentoznom lechenii legochnoi arterial'noi gipertenzii: stimuliator rastvorimoi guanilattsiklazy – riotsiguat. Evraziiskii kardiol. zhurn. 2015; 4: 12–9. [in Russian]
32. Adempas. Instruktsiia po primeneniiu lekarstvennogo preparata dlia meditsinskogo primeneniia. LP-002639-250914. http://grls.rosminzdrav.ru/ImgInstr.aspx?folder=ScanVavilova&Filepath=\Vneseno_v_Grls\441575... [in Russian]
33. Rubin LJ, Galiè N, Grimminger F et al. Riociguat for the treatment of pulmonary arterial hypertension: a long-term extension study (PATENT-2). Eur Respir J 2015; 45: 1303–13.
34. Galiè N, Muller K, Scalise AV, Grunig E. PATENT PLUS: a blinded, randomised and extension study of riociguat plus sildenafil in PAH. Eur Respir J 2015; 45: 1314–22.
35. Bayer AG. Adempas (riociguat tablets): EU summary of product characteristics. www.ema.europa.eu/docs/en_GB/ document_library/EPAR_-_Product_Information/human/002737/WC500165034.pdf Date last updated: March 27, 2014. Accessed: 2017.
36. Bayer AG. Adempas: US prescribing information. http://labeling.bayerhealthcare.com/html/products/pi/Adempas_ PI.pdf Date last updated: February 23, 2014. Accessed: 2017.
37. REPLACE. Riociguat replacing PDE-5i therapy evaluated against continued PDE-5i therapy. Сlinical Trials.gov Identifier: NCT02891850.
38. Taichman DB, Ornelas J, Chung L et al. Pharmacologic therapy for pulmonary arterial hypertension in adults: CHEST guideline and expert panel report. Chest 2014; 146 (2): 449–75.
39. Politi M, Caruso N, Lescano J et al. Switch from bosentan to macitentan in adult outpatients with pulmonary arterial hypertension: a real-world study. J Heart Lung Transplant 2017; 36: 4 (Suppl.): S166.
40. Blok IM, van Riel ACMJ, van Dijk APJ et al. From bosentan to macitentan for pulmonary arterial hypertension and adult congenital heart disease: Further improvement? Int J Cardiol 2017; 227: 51–2.
41. Safdar Z, Thakur A, Frost A. Tolerability of switch to macitentan from bosentan in pulmonary arterial hypertension. South Med J 2017; 110: 223–8.
42. Sitbon O, Manes A, Jais X et al. Rapid switch from intravenous epoprostenol to intravenous treprostinil in patients with pulmonary arterial hypertension. J Cardiovasc Pharmacol 2007; 49: 1–5.
43. Coons JC, Miller T, Simon MA et al. Oral treprostinil for the treatment of pulmonary arterial hypertension in patients transitioned from parenteral or inhaled prostacyclins: case series and treatment protocol. Pulm Circ 2016; 6: 132–5.
44. Lichtblau M, Harzheim D, Ehlken N et al. Safety and long-term efficacy of transition from sildenafil to tadalafil due to side effects in patients with pulmonary arterial hypertension. Lung 2015; 193: 105–12.
45. Dos Santos Fernandes CJC, Humbert M, Souza R. Challenging the concept of adding more drugs in pulmonary arterial hypertension. Eur Respir J 2017; 50: 1701527 https://doi.org/10.1183/13993003.01527-2017.
2. Легочная гипертензия. Российские клинические рекомендации, 2016. http://cr.rosminzdrav.ru/ schema.html?id=136#/text / Legochnaia gipertenziia. Rossiiskie klinicheskie rekomendatsii, 2016. http://cr.rosminzdrav.ru/schema.html?id=136#/text [in Russian]
3. Galiè N, Simonneau G. (eds). Updates in Pulmonary Hypertension Proceedings of the 5th World Symposium on Pulmonary Hypertension. J Am Coll Cardiol 2013; 62 (25; Suppl. D).
4. Galiè N, Humbert M, Vachiery JL et al. 2015ESC/ERSGuidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 2016; 37 (1).
5. Galiè N, Humbert M, Vachiery JL и соавт. Рекомендации ESC/ERS по диагностике и лечению легочной гипертензии. Рос. кардиол. журн. 2016; 5 (133): 5–64. / Galiè N, Humbert M, Vachiery JL i soavt. Rekomendatsii ESC/ERS po diagnostike i lecheniiu legochnoi gipertenzii. Ros. kardiol. zhurn. 2016; 5 (133): 5–64. [in Russian]
6. Hoeper MM, Simonneau G, Corris PA et al. RESPITE: switching to riociguat in pulmonaryarterialhypertensionpatients with inadequateresponse to phosphodiesterase-5inhibitors. Eur Respir J 2017; 50 (3): 1602425.
7. Madigan M, Zuckerbraun B. Therapeutic Potential of the Nitrite-Generated NO Pathway in Vascular Dysfunction. Front Immunol 2013; 4: 174.
8. Wilkins MR. Pulmonary hypertension: the science behind the disease spectrum. Eur Respir Rev 2012; 21 (123): 19–26.
9. O’Callaghan DS, Savale L, Montari D et al. Treatment of pulmonary arterial hypertension with targeted therapies. Nat Rev Cardiol 2011; 8: 526–38.
10. Ghofrani HA, Voswinckel R, Gall H et al. Riociguat for pulmonary hypertension. Future Cardiol 2010; 6: 155–66.
11. Stasch JP, Pacher P, Evgenov OV. Solubleguanylate cyclase as an emerging therapeutic target in cardiopulmonary disease. Circulation 2011; 123: 2263–73.
12. Ignarro LJ. NO More Heart Disease: How Nitric Oxide Can Prevent – Even Reverse – Heart Disease and Strokes. New York: St. Martin's Press; 2005.
13. Lundberg JO, Gladwin MT, Weitzberg E. Strategies to increasenitric oxidesignalling in cardiovascular disease. Nat Rev Drug Discov 2015; 14 (9): 623–41.
14. cGMP: Generators, Effectors and Therapeutic Implications. Ed. by: HH Schmidt, F Hofmann, JP Stasch. Handbook of Experimental Pharmacology 191. Springer-Verlag Berlin Heidelberg, 2009.
15. Stasch JP, Evgenov OV. Soluble Guanylate Cyclase Stimulators in Pulmonary Hypertension. In: Humbert et al. (eds.). Pharmacotherapy of Pulmonary Hypertension. Springer-Verlag Berlin Heidelberg, 2013; p. 279–313.
16. Cooper CJ, Landzberg MJ, Anderson TJ et al. Role of nitric oxide in the local regulation of pulmonary vascular resistance in humans. Circulation 1996; 93: 266 –71.
17. Koshland DE. The Molecule of the Year. Science 1992; 258: 1861.
18. Kielstein JT, Bode-Böger SM, Hesse G et al. Asymmetrical dimethylarginine in idiopathic pulmonary arterial hypertension. Arterioscler Thromb Vasc Biol 2005; 25 (7): 1414–8.
19. Giaid A, Saleh D. Reducedexpression of endothelial nitric oxide synthase in the lungs of patients with pulmonary hypertension. N Engl J Med 1995; 333 (4): 214–21.
20. Hemnes AR, Champion HC. Sildenafil, a PDE5 inhibitor, in the treatment of pulmonary hypertension. Exp Rev Cardiovasc Ther 2006; 4: 293–300.
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24. Sastry BK, Narasimhan C, Reddy NK, Raju BS. Clinical efficacy of sildenafil in primary pulmonary hypertension: a randomized, placebo-controlled, double-blind, crossover study. J Am Coll Cardiol 2004; 43 (7): 1149–53.
25. Singh TP, Rohit M, Grover A et al. A randomized, placebo-controlled, double-blind, crossover study to evaluate the efficacy of oralsildenafiltherapy in severepulmonary artery hypertension. Am Heart J 2006; 151 (4): 851.e1-5.
26. Guha M. First-in-class guanylate cyclase stimulator approved for PAH. Nat Biotechnol 2013; 31: 1064.
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35. Bayer AG. Adempas (riociguat tablets): EU summary of product characteristics. www.ema.europa.eu/docs/en_GB/ document_library/EPAR_-_Product_Information/human/002737/WC500165034.pdf Date last updated: March 27, 2014. Accessed: 2017.
36. Bayer AG. Adempas: US prescribing information. http://labeling.bayerhealthcare.com/html/products/pi/Adempas_ PI.pdf Date last updated: February 23, 2014. Accessed: 2017.
37. REPLACE. Riociguat replacing PDE-5i therapy evaluated against continued PDE-5i therapy. Сlinical Trials.gov Identifier: NCT02891850.
38. Taichman DB, Ornelas J, Chung L et al. Pharmacologic therapy for pulmonary arterial hypertension in adults: CHEST guideline and expert panel report. Chest 2014; 146 (2): 449–75.
39. Politi M, Caruso N, Lescano J et al. Switch from bosentan to macitentan in adult outpatients with pulmonary arterial hypertension: a real-world study. J Heart Lung Transplant 2017; 36: 4 (Suppl.): S166.
40. Blok IM, van Riel ACMJ, van Dijk APJ et al. From bosentan to macitentan for pulmonary arterial hypertension and adult congenital heart disease: Further improvement? Int J Cardiol 2017; 227: 51–2.
41. Safdar Z, Thakur A, Frost A. Tolerability of switch to macitentan from bosentan in pulmonary arterial hypertension. South Med J 2017; 110: 223–8.
42. Sitbon O, Manes A, Jais X et al. Rapid switch from intravenous epoprostenol to intravenous treprostinil in patients with pulmonary arterial hypertension. J Cardiovasc Pharmacol 2007; 49: 1–5.
43. Coons JC, Miller T, Simon MA et al. Oral treprostinil for the treatment of pulmonary arterial hypertension in patients transitioned from parenteral or inhaled prostacyclins: case series and treatment protocol. Pulm Circ 2016; 6: 132–5.
44. Lichtblau M, Harzheim D, Ehlken N et al. Safety and long-term efficacy of transition from sildenafil to tadalafil due to side effects in patients with pulmonary arterial hypertension. Lung 2015; 193: 105–12.
45. Dos Santos Fernandes CJC, Humbert M, Souza R. Challenging the concept of adding more drugs in pulmonary arterial hypertension. Eur Respir J 2017; 50: 1701527 https://doi.org/10.1183/13993003.01527-2017.
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15. Stasch JP, Evgenov OV. Soluble Guanylate Cyclase Stimulators in Pulmonary Hypertension. In: Humbert et al. (eds.). Pharmacotherapy of Pulmonary Hypertension. Springer-Verlag Berlin Heidelberg, 2013; p. 279–313.
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19. Giaid A, Saleh D. Reducedexpression of endothelial nitric oxide synthase in the lungs of patients with pulmonary hypertension. N Engl J Med 1995; 333 (4): 214–21.
20. Hemnes AR, Champion HC. Sildenafil, a PDE5 inhibitor, in the treatment of pulmonary hypertension. Exp Rev Cardiovasc Ther 2006; 4: 293–300.
21. Revatsio®. Instruktsiia po primeneniiu lekarstvennogo preparata dlia meditsinskogo primeneniia. LP-000197-13052014. http://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=59d051ad-f651-452e-acbd-aaae0b671b74&am... [in Russian]
22. Galiè N, Ghofrani HA, Torbicki A et al. Sildenafil citrate therapy for pulmonary arterial hypertension. New Engl J Med 2005; 353: 2148–2157.
23. Simonneau G, Rubin LJ, Galiè N al. Addition of sildenafil to long-term intravenous epoprostenol therapy in patients with pulmonary arterial hypertension:a randomized trial. Ann Intern Med 2008; 149: 521–30.
24. Sastry BK, Narasimhan C, Reddy NK, Raju BS. Clinical efficacy of sildenafil in primary pulmonary hypertension: a randomized, placebo-controlled, double-blind, crossover study. J Am Coll Cardiol 2004; 43 (7): 1149–53.
25. Singh TP, Rohit M, Grover A et al. A randomized, placebo-controlled, double-blind, crossover study to evaluate the efficacy of oralsildenafiltherapy in severepulmonary artery hypertension. Am Heart J 2006; 151 (4): 851.e1-5.
26. Guha M. First-in-class guanylate cyclase stimulator approved for PAH. Nat Biotechnol 2013; 31: 1064.
27. Pulido T, Adzerikho I, Channick RN et al. Macitentan and morbidity and mortalityin pulmonary arterial hypertension. N Engl J Med 2013; 369: 809–18.
28. Evgenov OV, Pacher P, Schmidt PM et al. NO-independentstimulators and activators of soluble guanylate cyclase: discovery and therapeuticpotential. Nat Rev Drug Discov 2006; 5 (9): 755–68.
29. Mittendorf J, Weigand S, Alonso-Alija C et al. Discovery of riociguat (BAY 63-2521): a potent, oral stimulator of soluble guanylate cyclase for the treatment of pulmonary hypertension. Chem Med Chem 2009; 4: 853–65.
30. Ghofrani HA, Galiè N, Grimminger F, Grünig E et al. Riociguat for the treatment of pulmonary arterial hypertension. N Engl J Med 2013; 369: 330–40.
31. Taran I.N., Martyniuk T.V., Nakonechnikov S.N., Chazova I.E. Innovatsiia v medikamentoznom lechenii legochnoi arterial'noi gipertenzii: stimuliator rastvorimoi guanilattsiklazy – riotsiguat. Evraziiskii kardiol. zhurn. 2015; 4: 12–9. [in Russian]
32. Adempas. Instruktsiia po primeneniiu lekarstvennogo preparata dlia meditsinskogo primeneniia. LP-002639-250914. http://grls.rosminzdrav.ru/ImgInstr.aspx?folder=ScanVavilova&Filepath=\Vneseno_v_Grls\441575... [in Russian]
33. Rubin LJ, Galiè N, Grimminger F et al. Riociguat for the treatment of pulmonary arterial hypertension: a long-term extension study (PATENT-2). Eur Respir J 2015; 45: 1303–13.
34. Galiè N, Muller K, Scalise AV, Grunig E. PATENT PLUS: a blinded, randomised and extension study of riociguat plus sildenafil in PAH. Eur Respir J 2015; 45: 1314–22.
35. Bayer AG. Adempas (riociguat tablets): EU summary of product characteristics. www.ema.europa.eu/docs/en_GB/ document_library/EPAR_-_Product_Information/human/002737/WC500165034.pdf Date last updated: March 27, 2014. Accessed: 2017.
36. Bayer AG. Adempas: US prescribing information. http://labeling.bayerhealthcare.com/html/products/pi/Adempas_ PI.pdf Date last updated: February 23, 2014. Accessed: 2017.
37. REPLACE. Riociguat replacing PDE-5i therapy evaluated against continued PDE-5i therapy. Сlinical Trials.gov Identifier: NCT02891850.
38. Taichman DB, Ornelas J, Chung L et al. Pharmacologic therapy for pulmonary arterial hypertension in adults: CHEST guideline and expert panel report. Chest 2014; 146 (2): 449–75.
39. Politi M, Caruso N, Lescano J et al. Switch from bosentan to macitentan in adult outpatients with pulmonary arterial hypertension: a real-world study. J Heart Lung Transplant 2017; 36: 4 (Suppl.): S166.
40. Blok IM, van Riel ACMJ, van Dijk APJ et al. From bosentan to macitentan for pulmonary arterial hypertension and adult congenital heart disease: Further improvement? Int J Cardiol 2017; 227: 51–2.
41. Safdar Z, Thakur A, Frost A. Tolerability of switch to macitentan from bosentan in pulmonary arterial hypertension. South Med J 2017; 110: 223–8.
42. Sitbon O, Manes A, Jais X et al. Rapid switch from intravenous epoprostenol to intravenous treprostinil in patients with pulmonary arterial hypertension. J Cardiovasc Pharmacol 2007; 49: 1–5.
43. Coons JC, Miller T, Simon MA et al. Oral treprostinil for the treatment of pulmonary arterial hypertension in patients transitioned from parenteral or inhaled prostacyclins: case series and treatment protocol. Pulm Circ 2016; 6: 132–5.
44. Lichtblau M, Harzheim D, Ehlken N et al. Safety and long-term efficacy of transition from sildenafil to tadalafil due to side effects in patients with pulmonary arterial hypertension. Lung 2015; 193: 105–12.
45. Dos Santos Fernandes CJC, Humbert M, Souza R. Challenging the concept of adding more drugs in pulmonary arterial hypertension. Eur Respir J 2017; 50: 1701527 https://doi.org/10.1183/13993003.01527-2017.
Авторы
А.А.Шмальц*, С.В.Горбачевский
ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии имени А.Н.Бакулева» Минздрава России. 121552, Россия, Москва, Рублевское ш., д. 135;
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России. 125993, Россия, Москва, ул. Баррикадная, д. 2
*shmaltzanton@inbox.ru
A.N.Bakulev National Medical Research Center of Cardiovascular Surgery of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, Rublevskoe sh., d. 135;
Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation. 125995, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1
*shmaltzanton@inbox.ru
ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии имени А.Н.Бакулева» Минздрава России. 121552, Россия, Москва, Рублевское ш., д. 135;
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России. 125993, Россия, Москва, ул. Баррикадная, д. 2
*shmaltzanton@inbox.ru
________________________________________________
A.N.Bakulev National Medical Research Center of Cardiovascular Surgery of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, Rublevskoe sh., d. 135;
Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation. 125995, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1
*shmaltzanton@inbox.ru
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