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Оптимизация специфической терапии легочной гипертензии: возможности риоцигуата
Мартынюк Т.В., Шмальц А.А., Горбачевский С.В., Чазова И.Е. Оптимизация специфической терапии легочной гипертензии: возможности риоцигуата. Терапевтический архив. 2021; 93 (9): 1117–1124. DOI: 10.26442/00403660.2021.09.201014
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Martynyuk TV, Shmalts AA, Gorbachevsky SV, Chazova IE. Optimization of specific therapy for pulmonary hypertension: the possibilities of riociguat. Terapevticheskii Arkhiv (Ter. Arkh.). 2021; 93 (9): 1117–1124. DOI: 10.26442/00403660.2021.09.201014
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Аннотация
Легочная гипертензия (ЛГ) – тяжелое и часто быстро прогрессирующее заболевание с фатальным исходом. Эндотелиальная дисфункция при ЛГ сопровождается снижением продукции оксида азота. После рассмотрения механизмов действия и доказательной базы специфической терапии ингибиторами фосфодиэстеразы 5 (иФДЭ-5) и стимуляторами растворимой гуанилатциклазы проводится обзор исследований по переключению с иФДЭ-5 на риоцигуат. Потенциальным преимуществом риоцигуата является независимость от эндогенного оксида азота и других (помимо ФДЭ-5) изоферментов фосфодиэстераз. Благоприятный профиль эффективности силденафила доказан для основных форм легочной артериальной гипертензии, риоцигуата – для основных форм легочной артериальной гипертензии и хронической тромбоэмболической ЛГ. Клиническая эффективность замены иФДЭ-5 на риоцигуат показана в неконтролируемых исследованиях и рандомизированном контролируемом исследовании REPLACE. Возможность оптимизации терапии за счет переключения с иФДЭ-5 на риоцигуат закреплена в российских (класс и уровень доказательности B-3) и евразийских (класс и уровень доказательности IIb-B) клинических рекомендациях, а также в материалах Кельнского консенсуса экспертов. Дополнительным аргументом за переключение в условиях Российской Федерации служит меньшая стоимость по сравнению с комбинированной терапией. Согласно российским и евразийским рекомендациям по ЛГ и российской инструкции по применению риоцигуата его прием следует начинать не ранее чем через 24 ч после отмены силденафила.
Ключевые слова: легочная гипертензия, специфическая терапия, силденафил, риоцигуат, оптимизация терапии
Ключевые слова: легочная гипертензия, специфическая терапия, силденафил, риоцигуат, оптимизация терапии
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Pulmonary hypertension (PH) is a severe and often rapidly progressive disease with fatal outcome. Endothelial dysfunction in PH is associated with decreased nitric oxide production. After reviewing the mechanisms of action and the evidence base for specific therapy with phosphodiesterase 5 inhibitors (PDE-5) and soluble guanylate cyclase stimulators, a reseach review on switching from PDE-5 to riociguat is conducted. A potential advantage of riociguat is its independence from endogenous nitric oxide and from the other (besides PDE-5) isoenzymes of phosphodiesterases. The favorable efficacy profile of sildenafil has been proven for the main forms of pulmonary arterial hypertension, of riociguat – for the main forms of pulmonary arterial hypertension and chronic thromboembolic PH. The clinical efficacy of replacing PDE-5 with riociguat has been demonstrated in uncontrolled trials and in the randomized controlled study REPLACE. The possibility of therapy optimization by switching from IFDE-5 to riociguat is fixed in the Russian (class and level of evidence B-3) and Eurasian (class and level of evidence IIb-B) clinical guidelines, as well as in the materials of the Cologne Expert Consensus. An additional argument for switching is the lower cost as compared to combination therapy in the Russian Federation. According to the Russian and Eurasian guidelines for PH and the Russian instructions for the use of riociguat, the drug should be taken at least 24 hours after sildenafil discontinuation.
Keywords: pulmonary hypertension, specific therapy, sildenafil, riociguat, therapy optimization
Полный текст
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6. Galié N, Humbert M, Vachiery JL, et al. 2015 ESC/ERS Guidelines 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):67-119. DOI:10.1093/eurheartj/ehv317
7. Stasch JP, Pacher P, Evgenov OV. Soluble guanylate cyclase as an emerging therapeutic target in cardiopulmonary disease. Circulation. 2011;123:2263-73.
8. Schlossmann J, Schinner E. cGMP becomes a drug target. Naunyn Schmiedebergs Arch Pharmacol. 2012;385(3):243-52. DOI:10.1007/s00210-012-0730-6
9. Evgenov OV, Pacher P, Schmidt PM, et al. NO-independent stimulators and activators of soluble guanylate cyclase: discovery and therapeutic potential. Nat Rev Drug Discov. 2006;5(9):755-68. DOI:10.1038/nrd2038
10. Giaid A, Saleh D. Reduced expression of endothelial nitric oxide synthase in the lungs of patients with pulmonary hypertension. N Engl J Med. 1995;333(4):214-21. DOI:10.1056/NEJM199507273330403
11. Ignarro LJ. NO More Heart Disease: How Nitric Oxide Can Prevent – Even Reverse – Heart Disease and Strokes. New York: St. Martin's Press, 2005.
12. Lundberg JO, Gladwin MT, Weitzberg E. Strategies to increase nitric oxide signalling in cardiovascular disease. Nat Rev Drug Discov. 2015;14(9):623-41.
13. cGMP: Generators, Effectors and Therapeutic Implications. Handbook of Experimental Pharmacology 191. Ed. HH Schmidt, F Hofmann, JP Stasch. Springer-Verlag Berlin Heidelberg, 2009.
14. Stasch JP, Evgenov OV. Soluble Guanylate Cyclase Stimulators in Pulmonary Hypertension. Handb Exp Pharmacol. 2013;218:279-313. DOI:10.1007/978-3-642-38664-0_12
15. 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.
16. 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.
17. Hemnes AR, Champion HC. Sildenafil, a PDE5 inhibitor, in the treatment of pulmonary hypertension. Expert Rev Cardiovasc Ther. 2006;4(3):293-300. DOI:10.1586/14779072.4.3.293
18. Galie N, Ghofrani HA, Torbicki A, et al. Sildenafil citrate therapy for pulmonary arterial hypertension. New Engl J Med. 2005;353(20):2148-57. DOI:10.1056/NEJMoa050010
19. Simonneau G, Rubin LJ, Galiè N, et al. Addition of sildenafil to long-term intravenous epoprostenol therapy in patients with pulmonary arterial hypertension: a randomized trial. Ann Intern Med. 2008;149(8):521-30. DOI:10.7326/0003-4819-149-8-200810210-00004
20. 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. DOI:10.1016/j.jacc.2003.10.056
21. Singh TP, Rohit M, Grover A, et al. A randomized, placebo-controlled, double-blind, crossover study to evaluate the efficacy of oral sildenafil therapy in severe pulmonary artery hypertension. Am Heart J. 2006;151(4):851.e1-5. DOI:10.1016/j.ahj.2005.09.006
22. Guha M. First-in-class guanylate cyclase stimulator approved for PAH. Nat Biotechnol. 2013;31(12):1064. DOI:10.1038/nbt1213-1064b
23. Ghofrani HA, Voswinckel R, Gall H, et al. Riociguat for pulmonary hypertension. Future Cardiol. 2010;6(2):155-66. DOI:10.2217/fca.10.5
24. Schermuly RT, Janssen W, Weissmann N, et al. Riociguat for the treatment of pulmonary hypertension. Expert Opin Investig Drugs. 2011;20(4):567-76. DOI:10.1517/13543784.2011.565048
25. Pulido T, Adzerikho I, Channick RN, et al. Macitentan and morbidity and mortality in pulmonary arterial hypertension. N Engl J Med. 2013;369(9):809-18. DOI:10.1056/NEJMoa1213917
26. 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(5):853-65. DOI:10.1002/cmdc.200900014
27. Ghofrani HA, Galiè N, Grimminger F, et al. Riociguat for the treatment of pulmonary arterial hypertension. N Engl J Med. 2013;369(4):330-40. DOI:10.1056/NEJMoa1209655
28. 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(5):1303-13. DOI:10.1183/09031936.00090614
29. Ghofrani HA, D'Armini AM, Grimminger F, et al. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension. N Engl J Med. 2013;369:319-29.
30. Galie 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(5):1314-22. DOI:10.1183/09031936.00105914
31. Чазова И.Е., Яровой С.Ю., Данилов Н.М. Эволюция патогенетической терапии легочной артериальной гипертензии. Терапевтический архив. 2019;91(12):4-9 [Chazova IE, Yarovoy SYu, Danilov NM. Evolution of pathogenetic therapy of pulmonary arterial hypertension. Terapevticheskii Arkhiv (Ter. Arkh.). 2019;91(12):4-9 (in Russian)]. DOI:10.26442/00403660.2019.12.000475
32. Шмальц А.А., Горбачевский С.В. Возможности и ограничения для начальной комбинированной специфической терапии легочной артериальной гипертензии в Российской Федерации. Терапевтический архив. 2020;92(12):80-5 [Shmalts AA, Gorbachevsky SV. Advantages and limitations of initial combination therapy in pulmonary arterial hypertensionpatients in Russia. Terapevticheskii Arkhiv (Ter. Arkh.). 2020;92(12):80-5 (in Russian)]. DOI:10.26442/00403660.2020.12.000840
33. Шмальц А.А., Горбачевский С.В. Систематический обзор как основа клинических рекомендаций: рекомендации CHEST-2019 по терапии легочной артериальной гипертензии у взрослых. Терапевтический архив. 2019;91(12):105-14 [Shmalts AA, Gorbachevsky SV. A systematic review as a method of gathering scientific evidence into clinical guidelines: CHEST-2019 guideline for the therapy pulmonary arterial hypertension in adults. Terapevticheskii Arkhiv (Ter. Arkh.). 2019;91(12):105-14 (in Russian)]. DOI:10.26442/00403660.2019.12.000468
34. Мартынюк Т.В., Наконечников С.Н., Чазова И.Е. Актуальные вопросы современной комбинированной специфической терапии легочной артериальной гипертензии: за и против. Медицинский совет. 2017;5:10-8 [Martyniuk TV, Nakonechnikov SN, Chazova IE. Aktual'nye voprosy sovremennoi kombinirovannoi spetsificheskoi terapii legochnoi arterial'noi gipertenzii: za i protiv. Meditsinskii sovet. 2017;5:10-8 (in Russian)].
35. Грацианская С.Е., Валиева З.С., Мартынюк Т.В. Достижения современной специфической терапии легочной артериальной и хронической тромбоэмболической легочной гипертензии: фокус на стимулятор растворимой гуанилатциклазы риоцигуат. Терапевтический архив. 2020;92(9):77-84 [Gratsianskaya SE, Valieva ZS, Martynyuk TV. The achievements of the modern specific therapy of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: focus on the stimulator of soluble guanylate cyclase riociguat. Terapevticheskii Arkhiv (Ter. Arkh.). 2020;92(9):77-84 (in Russian)]. DOI: 10.26442/00403660.2020.09.000717
36. Валиева З.С., Таран И.Н., Мартынюк Т.В., Чазова И.Е. Современный взгляд на место риоцигуата в лечении легочной гипертензии. Терапевтический архив. 2018;90(4):55-9 [Valieva ZS, Taran IN, Martynyuk TV, Chazova IE. Modern view on the place of riociguat in the treatment of pulmonary hypertension. Terapevticheskii Arkhiv (Ter. Arkh.). 2018;90(4):55-9 (in Russian)]. DOI:10.26442/terarkh201890455-59
37. Шмальц А.А., Горбачевский С.В. Риоцигуат и силденафил в лечении легочной гипертензии: сходства и различия. Пульмонология. 2016;26(1):85-91 [Shmal'ts AA, Gorbachevskii SV. Riotsiguat i sildenafil v lechenii legochnoi gipertenzii: skhodstva i razlichiia. Pul'monologiia. 2016;26(1):85-91 (in Russian)]. DOI:10.18093/0869-0189-2016-26-1-85-91
38. Шмальц А.А., Горбачевский С.В. Биохимический путь оксида азота в терапии легочной артериальной гипертензии и результаты исследования RESPITE. Системные гипертензии. 2018;15(2):72-6 [Shmalts AA, Gorbachevsky SV. Nitrogen oxide biochemical pathway in pulmonary arterial hypertension therapy and REPLACE trial results. Systemic Hypertension. 2018;15(2):72-6 (in Russian)]. DOI:10.26442/2075-082X_2018.2.72-76
39. 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.
40. Liu HL, Chen XY, Li JR, et al. Efficacy and Safety of Pulmonary Arterial Hypertension-specific Therapy in Pulmonary Arterial Hypertension: A Meta-analysis of Randomized Controlled Trials. Chest. 2016;150(2):353-66. DOI:10.1016/j.chest.2016.03.031
41. Fox BD, Shtraichman O, Langleben D, et al. Combination Therapy for Pulmonary Arterial Hypertension: A Systematic Review and Meta-analysis. Can J Cardiol. 2016;32(12):1520-30. DOI:10.1016/j.cjca.2016.03.004
42. Lajoie AC, Lauzière G, Lega J-C, et al. Combination therapy versus monotherapy for pulmonary arterial hypertension: a meta-analysis. Lancet Respir Med. 2016;4(4):291-305. DOI:10.1016/S2213-2600(16)00027-8
43. Sofer A, Ryan MJ, Tedford RJ, et al. A systematic review of transition studies of pulmonary arterial hypertension specific medications. Pulm Circ. 2017;7(2):326-38. DOI:10.1177/2045893217706357
44. 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. DOI:10.1183/13993003.01527-2017
45. Hoeper MM, Simonneau G, Corris PA, et al. RESPITE: switching to riociguat in pulmonary arterial hypertension patients with inadequate response to phosphodiesterase-5 inhibitors. Eur Respir J. 2017;50(3):1602425. DOI:10.1183/13993003.02425-2016
46. Taran IN, Belevskaya AA, Saidova MA, et al. Initial Riociguat Monotherapy and Transition from Sildenafil to Riociguat in Patients with Idiopathic Pulmonary Arterial Hypertension: Influence on Right Heart Remodeling and Right Ventricular-Pulmonary Arterial Coupling. Lung. 2018;196(6):745-53. DOI:10.1007/s00408-018-0160-4
47. McLaughlin VV, Jansa P, Nielsen-Kudsk JE, et al. Riociguat in patients with chronic thromboembolic pulmonary hypertension: results from an early access study. BMC Pulm Med. 2017;17(1):216. DOI:10.1186/s12890-017-0563-7
48. Davey R, Benza RL, Murali S, Raina A. Phosphodiesterase type 5 inhibitor to riociguat transition is associated with hemodynamic and symptomatic improvement in pulmonary hypertension. Pulm Circ. 2017;7(2):539-42. DOI:10.1177/2045893217708566
49. Andersen A, Korsholm K, Mellemkjær S, Nielsen-Kudsk JE. Switching from sildenafil to riociguat for the treatment of PAH and inoperable CTEPH: Real-life experiences. Respir Med Case Rep. 2017;22:39-43. DOI:10.1016/j.rmcr.2017.06.005
50. Raina A, Benza RL, Farber HW. Replacing a phosphodiesterase-5 inhibitor with riociguat in patients with connective tissue disease-associated pulmonary arterial hypertension: a case series. Pulm Circ. 2017;7(3):741-6. DOI:10.1177/2045893217721694
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53. Kuroda K, Akagi S, Nakamura K, et al. Successful Transition From Phosphodiesterase-5 Inhibitors to Riociguat Without a Washout Period in Patients With Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension: A Pilot Cohort Study. Heart Lung Circ. 2020;29(3):331-6. DOI:10.1016/j.hlc.2019.01.013
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________________________________________________
1. Koshland DE. The Molecule of the Year. Science. 1992;258:1861.
2. Pulmonary hypertension. Ed. IE Chazova, TV Martyniuk. Moscow: Practice, 2015; p. 55-103 (in Russian).
3. Pulmonary hypertension, including chronic thromboembolic pulmonary hypertension. Russian clinical guidelines. 2020. Available at: https://cr.minzdrav.gov.ru/recomend/159_1. Accessed: 18.08.2021 (in Russian).
4. Chazova IE, Martyniuk TV, Valieva ZS, et al. Eurasian clinical guidelines for the diagnosis and treatment of pulmonary hypertension (2019). Eurasian Journal of Cardiology. 2020;1:78-124 (in Russian). DOI:10.24411/2076-4766-2020-10002
5. Chazova IE, Martyniuk TV, Valieva ZS, et al. Eurasian guidelines for the diagnosis and treatment of chronic thromboembolic pulmonary hypertension (2020). Eurasian Journal of Cardiology. 2021;1:6-43 (in Russian). DOI:10.38109/2225-1685-2021-1-6-43
6. Galié N, Humbert M, Vachiery JL, et al. 2015 ESC/ERS Guidelines 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):67-119. DOI:10.1093/eurheartj/ehv317
7. Stasch JP, Pacher P, Evgenov OV. Soluble guanylate cyclase as an emerging therapeutic target in cardiopulmonary disease. Circulation. 2011;123:2263-73.
8. Schlossmann J, Schinner E. cGMP becomes a drug target. Naunyn Schmiedebergs Arch Pharmacol. 2012;385(3):243-52. DOI:10.1007/s00210-012-0730-6
9. Evgenov OV, Pacher P, Schmidt PM, et al. NO-independent stimulators and activators of soluble guanylate cyclase: discovery and therapeutic potential. Nat Rev Drug Discov. 2006;5(9):755-68. DOI:10.1038/nrd2038
10. Giaid A, Saleh D. Reduced expression of endothelial nitric oxide synthase in the lungs of patients with pulmonary hypertension. N Engl J Med. 1995;333(4):214-21. DOI:10.1056/NEJM199507273330403
11. Ignarro LJ. NO More Heart Disease: How Nitric Oxide Can Prevent – Even Reverse – Heart Disease and Strokes. New York: St. Martin's Press, 2005.
12. Lundberg JO, Gladwin MT, Weitzberg E. Strategies to increase nitric oxide signalling in cardiovascular disease. Nat Rev Drug Discov. 2015;14(9):623-41.
13. cGMP: Generators, Effectors and Therapeutic Implications. Handbook of Experimental Pharmacology 191. Ed. HH Schmidt, F Hofmann, JP Stasch. Springer-Verlag Berlin Heidelberg, 2009.
14. Stasch JP, Evgenov OV. Soluble Guanylate Cyclase Stimulators in Pulmonary Hypertension. Handb Exp Pharmacol. 2013;218:279-313. DOI:10.1007/978-3-642-38664-0_12
15. 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.
16. 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.
17. Hemnes AR, Champion HC. Sildenafil, a PDE5 inhibitor, in the treatment of pulmonary hypertension. Expert Rev Cardiovasc Ther. 2006;4(3):293-300. DOI:10.1586/14779072.4.3.293
18. Galie N, Ghofrani HA, Torbicki A, et al. Sildenafil citrate therapy for pulmonary arterial hypertension. New Engl J Med. 2005;353(20):2148-57. DOI:10.1056/NEJMoa050010
19. Simonneau G, Rubin LJ, Galiè N, et al. Addition of sildenafil to long-term intravenous epoprostenol therapy in patients with pulmonary arterial hypertension: a randomized trial. Ann Intern Med. 2008;149(8):521-30. DOI:10.7326/0003-4819-149-8-200810210-00004
20. 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. DOI:10.1016/j.jacc.2003.10.056
21. Singh TP, Rohit M, Grover A, et al. A randomized, placebo-controlled, double-blind, crossover study to evaluate the efficacy of oral sildenafil therapy in severe pulmonary artery hypertension. Am Heart J. 2006;151(4):851.e1-5. DOI:10.1016/j.ahj.2005.09.006
22. Guha M. First-in-class guanylate cyclase stimulator approved for PAH. Nat Biotechnol. 2013;31(12):1064. DOI:10.1038/nbt1213-1064b
23. Ghofrani HA, Voswinckel R, Gall H, et al. Riociguat for pulmonary hypertension. Future Cardiol. 2010;6(2):155-66. DOI:10.2217/fca.10.5
24. Schermuly RT, Janssen W, Weissmann N, et al. Riociguat for the treatment of pulmonary hypertension. Expert Opin Investig Drugs. 2011;20(4):567-76. DOI:10.1517/13543784.2011.565048
25. Pulido T, Adzerikho I, Channick RN, et al. Macitentan and morbidity and mortality in pulmonary arterial hypertension. N Engl J Med. 2013;369(9):809-18. DOI:10.1056/NEJMoa1213917
26. 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(5):853-65. DOI:10.1002/cmdc.200900014
27. Ghofrani HA, Galiè N, Grimminger F, et al. Riociguat for the treatment of pulmonary arterial hypertension. N Engl J Med. 2013;369(4):330-40. DOI:10.1056/NEJMoa1209655
28. 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(5):1303-13. DOI:10.1183/09031936.00090614
29. Ghofrani HA, D'Armini AM, Grimminger F, et al. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension. N Engl J Med. 2013;369:319-29.
30. Galie 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(5):1314-22. DOI:10.1183/09031936.00105914
31. Chazova IE, Yarovoy SYu, Danilov NM. Evolution of pathogenetic therapy of pulmonary arterial hypertension. Terapevticheskii Arkhiv (Ter. Arkh.). 2019;91(12):4-9 (in Russian). DOI:10.26442/00403660.2019.12.000475
32. Shmalts AA, Gorbachevsky SV. Advantages and limitations of initial combination therapy in pulmonary arterial hypertensionpatients in Russia. Terapevticheskii Arkhiv (Ter. Arkh.). 2020;92(12):80-5 (in Russian). DOI:10.26442/00403660.2020.12.000840
33. Shmalts AA, Gorbachevsky SV. A systematic review as a method of gathering scientific evidence into clinical guidelines: CHEST-2019 guideline for the therapy pulmonary arterial hypertension in adults. Terapevticheskii Arkhiv (Ter. Arkh.). 2019;91(12):105-14 (in Russian). DOI:10.26442/00403660.2019.12.000468
34. Martyniuk TV, Nakonechnikov SN, Chazova IE. Aktual'nye voprosy sovremennoi kombinirovannoi spetsificheskoi terapii legochnoi arterial'noi gipertenzii: za i protiv. Meditsinskii sovet. 2017;5:10-8 (in Russian).
35. Gratsianskaya SE, Valieva ZS, Martynyuk TV. The achievements of the modern specific therapy of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: focus on the stimulator of soluble guanylate cyclase riociguat. Terapevticheskii Arkhiv (Ter. Arkh.). 2020;92(9):77-84 (in Russian). DOI: 10.26442/00403660.2020.09.000717
36. Valieva ZS, Taran IN, Martynyuk TV, Chazova IE. Modern view on the place of riociguat in the treatment of pulmonary hypertension. Terapevticheskii Arkhiv (Ter. Arkh.). 2018;90(4):55-9 (in Russian). DOI:10.26442/terarkh201890455-59
37. Shmal'ts AA, Gorbachevskii SV. Riotsiguat i sildenafil v lechenii legochnoi gipertenzii: skhodstva i razlichiia. Pul'monologiia. 2016;26(1):85-91 (in Russian). DOI:10.18093/0869-0189-2016-26-1-85-91
38. Shmalts AA, Gorbachevsky SV. Nitrogen oxide biochemical pathway in pulmonary arterial hypertension therapy and REPLACE trial results. Systemic Hypertension. 2018;15(2):72-6 (in Russian). DOI:10.26442/2075-082X_2018.2.72-76
39. 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.
40. Liu HL, Chen XY, Li JR, et al. Efficacy and Safety of Pulmonary Arterial Hypertension-specific Therapy in Pulmonary Arterial Hypertension: A Meta-analysis of Randomized Controlled Trials. Chest. 2016;150(2):353-66. DOI:10.1016/j.chest.2016.03.031
41. Fox BD, Shtraichman O, Langleben D, et al. Combination Therapy for Pulmonary Arterial Hypertension: A Systematic Review and Meta-analysis. Can J Cardiol. 2016;32(12):1520-30. DOI:10.1016/j.cjca.2016.03.004
42. Lajoie AC, Lauzière G, Lega J-C, et al. Combination therapy versus monotherapy for pulmonary arterial hypertension: a meta-analysis. Lancet Respir Med. 2016;4(4):291-305. DOI:10.1016/S2213-2600(16)00027-8
43. Sofer A, Ryan MJ, Tedford RJ, et al. A systematic review of transition studies of pulmonary arterial hypertension specific medications. Pulm Circ. 2017;7(2):326-38. DOI:10.1177/2045893217706357
44. 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. DOI:10.1183/13993003.01527-2017
45. Hoeper MM, Simonneau G, Corris PA, et al. RESPITE: switching to riociguat in pulmonary arterial hypertension patients with inadequate response to phosphodiesterase-5 inhibitors. Eur Respir J. 2017;50(3):1602425. DOI:10.1183/13993003.02425-2016
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Авторы
Т.В. Мартынюк*1,2, А.А. Шмальц3,4, С.В. Горбачевский3,4, И.Е. Чазова1
1 ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва, Россия;
2 ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия;
3 ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева» Минздрава России, Москва, Россия;
4 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия
*trukhiniv@mail.ru
1 ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва, Россия;
2 ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия;
3 ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева» Минздрава России, Москва, Россия;
4 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия
*trukhiniv@mail.ru
________________________________________________
Tamila V. Martynyuk*1,2, Anton A. Shmalts3,4, Sergey V. Gorbachevsky3,4, Irina E. Chazova1
1 National Medical Research Center of Cardiology, Moscow, Russia;
2 Pirogov Russian National Research Medical University, Moscow, Russia;
3 Bakoulev National Medical Research Center of Cardiovascular Surgery, Moscow, Russia;
4 Russian Medical Academy of Continuous Professional Education, Moscow, Russia
*trukhiniv@mail.ru
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