cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2020.4.n1026cardio-1026Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИRESEARCH ARTICLESОпыт применения лекарственного препарата селексипаг в лечении пациентов с легочной артериальной гипертензиейExperience with Selexipag to Treat Pulmonary Arterial Hypertensionhttps://orcid.org/0000-0002-3655-9709КарелкинаЕ. В.KarelkinaE. V.

научный сотрудник НИО некоронарогенных заболеваний сердца

Researcher of Non coronary Heart Disease Depertment

karelkina_ev@almazovcentre.ruhttps://orcid.org/0000-0001-6954-7096ГончароваН. С.GoncharovaN. S.

к.м.н., старший научный сотрудник НИО некоронарогенных заболеваний сердца

Senior Researcher of Non coronary Heart Disease Depertment

goncharova_ns@almazovcentre.ruhttps://orcid.org/0000-0001-9478-1941СимаковаМ. А.SimakovaM. A.

к.м.н., старший научный сотрудник НИО некоронарогенных заболеваний сердца

Senior Researcher of Non coronary Heart Disease Depertment

maria.simakova@gmail.comhttps://orcid.org/0000-0002-7817-3847МоисееваО. М.MoiseevaO. M.

главный научный сотрудник, руководитель НИО некоронарогенных заболеваний сердца, д.м.н.

SPIN 1492-3900

Chief Researcher, Head  of Non coronary Heart Disease Depertment

moiseeva.cardio@gmail.comФГБУ "НМИЦ им. В.А. Алмазова" Минздрава РоссииРоссияAlmazov National medical research CentreRussian FederationФГБУ «НМИЦ имени В. А. Алмазова»РоссияAlmazov National medical research CentreRussian Federation2020300320206043642Copyright © Kardiomag, 20202020KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/1026

Цель Представить собственный опыт применения лекарственного препарата селексипаг на примере пациентов с легочной артериальной гипертензией (ЛАГ), включенных в регистр ФГБУ «НМИЦ им. В. А. Алмазова» и принимавших участие в клинических исследованиях GRIPHON и GRIPHON OL.Материал и методы С 2010 г. в исследование включены 26 пациентов с ЛАГ: 20 – с идиопатической ЛАГ, 4 – с ЛАГ, ассоциированной с системной склеродермией, и 2 – с корригированными врожденными пороками сердца. На момент рандомизации 19 пациентов в течение не менее 1 мес получали терапию ингибиторами фосфодиэстеразы 5 го типа. Среди пациентов, получавших селексипаг (n=14), 4 достигли высокой индивидуальной поддерживающей дозы (1200–1600 мкг 2 раза в сутки), 4 – средней дозы (600–1000 мкг 2 раза в сутки) и 6 пациентов – низкой дозы (200–400 мкг 2 раза в сутки).Результаты Отмечено положительное влияние терапии селексипагом на вторичные конечные точки, в частности, на динамику функционального класса легочной гипертензии, уровень NT-proBNP в сыворотке крови и физическую работоспособность пациентов. Нежелательные явления, связанные с приемом селексипага, которые стали причиной прекращения дальнейшего участия в исследовании, наблюдались у одного больного.Заключение Для достижения основной цели лекарственной терапии – низкого риска смерти – при назначении селексипага необходимо соблюдать режим титрации и стремиться к достижению максимально высокой индивидуальной поддерживающей дозы.

Aim To present an own experience in using a medication selexipag in patients with pulmonary arterial hypertension (PAH) included into the V. A. Almazov National Medical Research Center registry and participating in the GRIPHON and GRIPHON OL clinical studies.Material and methods 26 patients with PAH were included into this study since 2010: 20 patients with idiopathic PAH, 4 patients with PAH associated with systemic scleroderma, and 2 patients with corrected congenital heart defects. At the time of randomization, 19 patients had been receiving therapy with phosphodiesterase type 5 inhibitors for at least one month. Among the patients treated with selexipag (n=14), 4 patients reached a high individual maintenance dose (1200–1600 µg b.i.d.), 4 patients reached a medium dose (600–1000 µg b.i.d.), and 6 patients reached a low dose (200–400 µg b.i.d.).Results The selexipag therapy exerted a positive effect on secondary endpoints, specifically, on changes in the functional class of pulmonary hypertension, serum concentration of NT-proBNP, and physical working capacity of patients. Adverse events associated with the selexipag treatment, which resulted in termination of study participation, were observed in one patient.Conclusion To achieve the main goal of drug therapy, low risk of death with selexipag it is critical to observe the titration schedule and to aim at reaching the highest individual maintenance dose.

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The authors declare that there are no conflicts of interest present.