Role of Selexipag in Chronic Obstructive Pulmonary Disease (COPD) Patients With Out-of-Proportion Pulmonary Hypertension.

Sherif T Abuserewa,Ahmed Selim,Amr Youssef,Ronald Zolty

doi:10.7759/cureus.16520

Sherif T Abuserewa, Ahmed Selim + Show 2 more

Open Access

https://doi.org/10.7759/cureus.16520

Copy DOI

Journal: Cureus	Publication Date: Jul 20, 2021
Citations: 2	License type: cc-by

Abstract

Pulmonary hypertension (PH) in patients with chronic obstructive pulmonary disease (COPD) is associated with an increase in the risk of COPD exacerbation, increased hospitalization, and worse survival in this patient population. No specific treatment is available for PH in COPD. However, reported out-of-proportion PH may benefit from a certain type of treatment. This study shows that the use of selexipag in the treatment of out-of-proportion PH in COPD patients was associated with an improvement in functional status evaluated by a six-minute walk test (6MWT) and a mean pulmonary artery pressure at 6 +/- 2 months of treatment.

Highlights

Pulmonary hypertension (PH) is defined as an increase in the mean pulmonary artery pressure of ⩾ 20 mmHg at rest or >30 mmHg during exercise, which can complicate left heart and pulmonary diseases and result in right heart failure [1,2]
We reviewed the medical records of chronic obstructive pulmonary disease (COPD) patients who were started on selexipag for out-of-proportion pulmonary hypertension
The patient's functional status was assessed by 6MWT which has improved after treatment with selexipag with a total mean change of 97 meters

Summary

Introduction

Pulmonary hypertension (PH) is defined as an increase in the mean pulmonary artery pressure (mPAP) of ⩾ 20 mmHg at rest or >30 mmHg during exercise, which can complicate left heart and pulmonary diseases and result in right heart failure [1,2]. COPD patients with "out-of-proportion" pulmonary - where resting mPAP was ≥ 35 mmHg in the presence of relatively preserved lung function hypertension - underwent several trials using pulmonary arterial hypertension (PAH)-directed therapy, including prostacyclin agonists, phosphodiesterase type 5 (PDE-5) inhibitors, and nitric oxide-cyclic guanosine monophosphate enhancers. These studies showed mixed effects on resting and exercise-induced pulmonary hemodynamics, six-minute walk test (6MWT), and quality of life [4]. We will evaluate the effect of selexipag on functional capacity in COPD patients with out-ofproportion pulmonary hypertension through the 6MWT and mean pulmonary artery pressure before and after selexipag treatment

Methods

Results

Conclusion