Новая тактика лечения легочной гипертензии: переключение на более эффективную терапию

В статье рассматривается современная тактика терапии легочной гипертензии, применяемая в случае неудовлетворительного клинического ответа на предшествующее лечение. Представлены все классы препаратов для лечения легочной гипертензии, а также современные взгляды на стратификацию риска смерти пациентов в течение года. Обсуждается переключение на более эффективный препарат как в рамках одной группы патогенетической (специфической для легочной артериальной гипертензии) терапии, так и на препараты других классов. Представлена последняя классификация легочной гипертензии (Ницца, 2018).

1. Nickel N., Golpon H., Greer M. et al. The prognostic impact of follow-up assessments in patients with idiopathic pulmonary arterial hypertension. Eur Respir J 2012;39:589-596.

2. Galie N., Humbert M., Vachiery J. L. et al. 2015 ECS/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J 2016;37:67-119.

3. Чазова И. Е., Мартынюк Т. В., Авдеев С. Н. и др. Клинические рекомендации по диагностике и лечению легочной гипертензии. Терапевтический архив 2014;86 (9):4-23. https://doi.org/terape-vticheskij-arkhiv/2014/9/030040-3660201491

4. Simonneau G., Gatzolis G., Adatia I. et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 2013;62 (25 Suppl): D35-41.

5. McLaughlin V. V., Archer S. L., Badesch D. B. et al. ACCF /AHA 2009 expert consensus document on pulmonary hypertension: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and theAmerican Heart Association: developed in collaboration with the American College of Chest Physicians, American Thoracic Society, Inc., and the Pulmonary Hypertension Association. Circulation 2009;119:2250-229.

6. Hoeper M. M., Huscher D., Ghofrani H. A. et al. Elderly patients diagnosed with idiopathic pulmonary arterial hypertension: results from the COMPERA registry. Int J Cardiol 2013;168:871-880.

7. Humbert M., Sitbon O., Yaici A. et al. Survival in incident and prevalent cohort of patients with pulmonary arterial hypertension. Eur Respir J 2010;36:549-555.

8. Benza R. L., Miller D. P., Gomberg-Maitland M. et al. Predicting survival in pulmonary arterial hypertension: insights from the Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL). Circulation 2010;122:164-172.

9. Humbert M., Sitbon O., Simonneau G. Treatment of pulmonary arterial hypertension. N Engl J Med 2004;351:1425-1436.

10. Humbert M., Simonneau G., Rubin L.J. A decade of achievement in pulmonary hypertension. Eur Respir Rev 2011;20:215-217.

11. Pulido T., Adzerikho I., Channick R. N. et al. Macitentan and morbidity and mortality in pulmonary arterial hypertension. N Engl J Med 2013;369:809-818.

12. Sitbon O., Channick R., Chin K. M. et al. Selexipag for the treatment of pulmonary arterial hypertension. N Engl J Med 2015; 373: 2522-2533.

13. Galie N., Barbera J. A., Frost A. E. et al. Initial use of ambrisentan plus tadalafil in pulmonary arterial hypertension. N Engl J Med 2015;373:834-844.

14. Sitbon O., Jais X., Savale L. et al. Upfront triple combination therapy in pulmonary arterial hypertension: a pilot study. Eur Respir J 2014;43:1691-1697.

15. Sitbon O., Sattler C., Bertoletti L. et al. Initial dual oral combination therapy in pulmonary arterial hypertension. Eur Respir J 2016;47:1727-1736.

16. Galie N., Humbert M., Vachiery J. L. et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J 2015;46:903-975.

17. Hoeper M. M., Simonneau G., Corris P. A. et al. RESPITE: switching to riociguat in pulmonary arterial hypertension patients with inadequate response to phosphodiesterase-5 inhibitors. Eur Respir J 2017;50:1602425.

18. Царева Н. А., Авдеев С. Н., Неклюдова Г. В. Пациент с тяжелым течением идиопатической легочной артериальной гипертензии. Есть ли выход? Терапевтический архив 2017;89 (9):100-103.) https://doi.org/10.17116/terarkh2017899100-103

19. Sitbon O., Manes A., Jais X. et al. Rapid switch from intravenous epoprostenol to intravenous treprostinil in patients with pulmonary arterial hypertension. J Cardiovasc Pharmacol 2007;49:1-5.

20. Coons J. C., Miller T., Simon M. A. et al. Oral treprostinil for the treatment of pulmonary arterial hypertension in patients transitioned from parenteral or inhaled prostacyclins: case series and treatment protocol. Pulm Circ 2016;6:132-135.

21. Iglarz M., Binkert C., Morrison K. et al. Pharmacology of maci-tentan, an orally active tissue-targeting dual endothelin receptor antagonist. J Pharmacol Exp Ther 2008;327:736-745. https://doi.org/10.1124/jpet.108.142976.

22. Gatfield J., Mueller Grandjean C., Sasse T. et al. Slow receptor dissociation kinetics differentiate macitentan from other endothelin receptor antagonists in pulmonary arterial smooth muscle cells. PLoS ONE 2012;7: e47662. https://doi.org/10.1371/journal.pone.0047662

23. Patel T., McKeage K. Macitentan: first global approval. Drugs 2014;74:127-123. https://doi.org/10.1007/s40265-013-0156-6.

24. Khadka A., Singh Brashier D. B., Tejus A., Sharma A. K. Maci-tentan: an important addition to the treatment of pulmonary arterial hypertension. J Pharmacol Pharmacother 2015;6:53-57. https://doi.org/10.4103/0976-500X.149151.

25. Cadenas-Menendez S., Alvarez-Vega P., Martin-Moreiras J. et al. Macitentan in daily clinical practice: A single centre, 1-year experience. Rev Port Pneumologia 2017; 24 (3):170-173. https://doi.org/10.1016/j.rppnen.2017.10.001

26. Safdar Z., Thakur A., Frost A. Tolerability of switch to macitentan from bosentan in pulmonary arterial hypertension. South Med J 2017;110:223-228.

27. Politi M., Caruso N., Lescano J. et al. Switch from bosentan to maci-tentan in adult outpatients with pulmonary arterial hypertension: a real-world study. J Heart Lung Transplant 2017;36:4 Suppl.:S166.

28. Herbert S., Gin-Sing W., Howard L., Tulloh R. M. R. Early Experience of Macitentan for Pulmonary Arterial Hypertension in Adult Congenital Heart Disease. Heart, Lung and Circulation 2017;26 (10): 1113-1116. https://doi.org/10.1016/j.hlc.2016.12.011

29. Ilja M. Blok, Annelieke C. M. J. van Riel, Arie P.J. van Dijk et al. From bosentan to macitentan for pulmonary arterial hypertension and adult congenital heart disease: Further improvement? International Journal of Cardiology 2017;227:51-52.

30. Duffels M. G. J., Vis J. C., van Loon R. L. E. et al. Effect of bosen-tan on exercise capacity and quality of life in adults with pulmonary arterial hypertension associated with congenital heart disease with and without Down's syndrome, Am J Cardiol 2009;103:1309-1315.