Soluble guanylate cyclase stimulators and phosphodiesterase-5 inhibitors in therapy of some groups of pulmonary hypertension
https://doi.org/10.18093/0869-0189-2017-27-6-803-810
Abstract
Pulmonary hypertension (PH) is a large group of diseases characterized by pulmonary artery pressure (PAP) > 25 mm Hg. Currently, specific medications are available for several groups of PH only. These are prostacyclin analogues, soluble guanylate cyclase (sGC) stimulators (sGCS), phosphodiesterase-5 inhibitors (iPDE-5), and endothelin receptor antagonists. Modern evidence-based pharmacological treatment of PH and therapeutic algorithm have been described in this review. Particular attention was paid to mechanisms of dysregulation of vascular tone including nitric oxide (NO-sGC-cGMP) pathway that is a target for sGCS and iPDE-5. A new class of sGCS principally differs from iPDE-5 and is very important for clinical practice. Safety, availability and benefit of switching from iPDE-5 to riociguat was investigated in the RESPITE trial. Results of main clinical trials of efficacy and safety of riociguat in patients with pulmonary arterial hypertension and thromboembolic PH were also discussed in this review.
About the Author
K. I. Ivanov
Yakutiya Republic Hospital No.1 – National Medical Center
Russian Federation
Russian Federation
Kyundyul I. Ivanov, Doctor of Medicine, Director of Cardiological Clinic
Sergelyakhskoe shosse 4, Yakutsk, 677019, Sakha Republic (Yakutiya), Russia
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Review
For citations:
Ivanov K.I. Soluble guanylate cyclase stimulators and phosphodiesterase-5 inhibitors in therapy of some groups of pulmonary hypertension. PULMONOLOGIYA. 2017;27(6):803-810. (In Russ.) https://doi.org/10.18093/0869-0189-2017-27-6-803-810
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