Optimization of specific therapy for pulmonary hypertension: the possibilities of riociguat

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 inhibitor...

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Autores principales:	Tamila V. Martynyuk, Anton A. Shmalts, Sergey V. Gorbachevsky, Irina E. Chazova
Formato:	article
Lenguaje:	RU
Publicado:	"Consilium Medicum" Publishing house 2021
Materias:	pulmonary hypertension specific therapy sildenafil riociguat therapy optimization Medicine R
Acceso en línea:	https://doaj.org/article/79df2c4b933a4945b3d6168494d66700
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spelling	oai:doaj.org-article:79df2c4b933a4945b3d6168494d667002021-12-01T12:22:36ZOptimization of specific therapy for pulmonary hypertension: the possibilities of riociguat0040-36602309-534210.26442/00403660.2021.09.201014https://doaj.org/article/79df2c4b933a4945b3d6168494d667002021-09-01T00:00:00Zhttps://ter-arkhiv.ru/0040-3660/article/viewFile/82984/63482https://doaj.org/toc/0040-3660https://doaj.org/toc/2309-5342Pulmonary 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.Tamila V. MartynyukAnton A. ShmaltsSergey V. GorbachevskyIrina E. Chazova"Consilium Medicum" Publishing housearticlepulmonary hypertensionspecific therapysildenafilriociguattherapy optimizationMedicineRRUТерапевтический архив, Vol 93, Iss 9, Pp 1117-1124 (2021)
institution	DOAJ
collection	DOAJ
language	RU
topic	pulmonary hypertension specific therapy sildenafil riociguat therapy optimization Medicine R
spellingShingle	pulmonary hypertension specific therapy sildenafil riociguat therapy optimization Medicine R Tamila V. Martynyuk Anton A. Shmalts Sergey V. Gorbachevsky Irina E. Chazova Optimization of specific therapy for pulmonary hypertension: the possibilities of riociguat
description	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.
format	article
author	Tamila V. Martynyuk Anton A. Shmalts Sergey V. Gorbachevsky Irina E. Chazova
author_facet	Tamila V. Martynyuk Anton A. Shmalts Sergey V. Gorbachevsky Irina E. Chazova
author_sort	Tamila V. Martynyuk
title	Optimization of specific therapy for pulmonary hypertension: the possibilities of riociguat
title_short	Optimization of specific therapy for pulmonary hypertension: the possibilities of riociguat
title_full	Optimization of specific therapy for pulmonary hypertension: the possibilities of riociguat
title_fullStr	Optimization of specific therapy for pulmonary hypertension: the possibilities of riociguat
title_full_unstemmed	Optimization of specific therapy for pulmonary hypertension: the possibilities of riociguat
title_sort	optimization of specific therapy for pulmonary hypertension: the possibilities of riociguat
publisher	"Consilium Medicum" Publishing house
publishDate	2021
url	https://doaj.org/article/79df2c4b933a4945b3d6168494d66700
work_keys_str_mv	AT tamilavmartynyuk optimizationofspecifictherapyforpulmonaryhypertensionthepossibilitiesofriociguat AT antonashmalts optimizationofspecifictherapyforpulmonaryhypertensionthepossibilitiesofriociguat AT sergeyvgorbachevsky optimizationofspecifictherapyforpulmonaryhypertensionthepossibilitiesofriociguat AT irinaechazova optimizationofspecifictherapyforpulmonaryhypertensionthepossibilitiesofriociguat
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Optimization of specific therapy for pulmonary hypertension: the possibilities of riociguat

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