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Genin V, Horeau-Langlard D, Diot E, Gagnadoux F, Lavigne C, Fournet M, Durant C, Agard C. [Characteristics of patients with connective tissue disease-associated pulmonary arterial hypertension treated with prostanoids: A multicenter retrospective study]. Rev Med Interne 2021; 42:825-831. [PMID: 34462153 DOI: 10.1016/j.revmed.2021.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/18/2021] [Accepted: 07/25/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Pulmonary arterial hypertension (PAH) is a severe complication of connective tissue disease (CTD). Data on use of prostanoids in this particular subset of patients are lacking. We aimed to describe the characteristics of patients with PAH-CTD treated with prostanoids and the outcomes under treatment. METHODS In this multicenter retrospective study, all patients treated with prostanoids since 2006 were included. Data on PAH and CTD were collected at the time of prostanoid introduction and under treatment. RESULTS Twenty-one patients were included, of whom 20 (95%) had limited cutaneous systemic sclerosis. Nineteen patients were treated with oral monotherapy or combination before addition of prostanoid. Treprostinil was the most used molecule (57% of patients). At the time of prostanoid introduction, 90% of patients were considered at high risk for death. Among patients who had right heart catheterization during follow-up, there was no significant difference in haemodynamics. No extrarespiratory worsening of the CTD was reported. The 1-year survival under prostanoid was 62%. In univariate analysis, NYHA functional class was associated with survival under treatment. CONCLUSION This study provides original data on use of prostanoids in a cohort consisting mainly of systemic sclerosis. It underlines the difficulty to achieve a standardized assessment in this subset of patients. Safety profile was comparable with data reported in idiopathic PAH.
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Affiliation(s)
- V Genin
- Service de médecine interne, Hôtel-Dieu, CHU de Nantes, centre de compétence HTAP de l'adulte, 1, place Alexis-Ricordeau, 44000 Nantes, France.
| | - D Horeau-Langlard
- Service de pneumologie, hôpital Laennec, CHU de Nantes, centre de compétence HTAP de l'adulte, boulevard Jacques-Monod, Saint-Herblain, France
| | - E Diot
- Service de médecine interne, hôpital Bretonneau, CHRU de Tours, centre de compétence HTAP de l'adulte, 2, boulevard Tonnellé, Tours, France
| | - F Gagnadoux
- Service de pneumologie, CHU d'Angers, centre de compétence HTAP de l'adulte, 4, rue Larrey, Angers, France
| | - C Lavigne
- Service de médecine interne-immunologie clinique, CHU d'Angers, centre de compétence HTAP de l'adulte, 4, rue Larrey, Angers, France
| | - M Fournet
- Service de cardiologie, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri le Guilloux, 35000 Rennes, France
| | - C Durant
- Service de médecine interne, Hôtel-Dieu, CHU de Nantes, centre de compétence HTAP de l'adulte, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - C Agard
- Service de médecine interne, Hôtel-Dieu, CHU de Nantes, centre de compétence HTAP de l'adulte, 1, place Alexis-Ricordeau, 44000 Nantes, France
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