Universität zu Köln

Hoeper, Marius M., Apitz, Christian, Gruenig, Ekkehard, Halank, Michael, Ewert, Ralf, Kaemmerer, Harald, Kabitz, Hans-Joachim ORCID: 0000-0002-0080-7125, Kaehler, Christian, Klose, Hans, Leuchte, Hanno, Ulrich, Silvia ORCID: 0000-0002-5250-5022, Olsson, Karen M., Distler, Oliver ORCID: 0000-0002-0546-8310, Rosenkranz, Stephan and Ghofrani, H. Ardeschir (2018). Targeted therapy of pulmonary arterial hypertension: Updated recommendations from the Cologne Consensus Conference 2018. Int. J. Cardiol., 272. S. 37 - 46. CLARE: ELSEVIER IRELAND LTD. ISSN 1874-1754

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Abstract

In the summer of 2016, delegates from the German Respiratory Society, the German Society of Cardiology and the German Society of Pediatric Cardiology met in Cologne, Germany, to define consensus-based practice recommendations for the management of patients with pulmonary arterial hypertension (PAH). These recommendations were built on the 2015 European Pulmonary Hypertension guidelines and included new evidence, where available. The treatment algorithm for PAH was modified based on the observation that there are now many patients diagnosed with IPAH who are at an advanced age and have significant cardiopulmonary comorbidities. For patients newly diagnosed with classic forms of PAH, i.e. younger patients without significant cardiopulmonary comorbidities, the consensus-based recommendation was to use initial combination therapy as the standard approach. The use of monotherapies was no longer considered appropriate in such patients. The choice of treatment strategies should be based on the risk assessment as proposed in the European guidelines. In patients presenting with a low or intermediate risk, oral combination therapy with endothelin receptor antagonists and phosphodiesterase-5 inhibitors or soluble guanylate cyclase stimulators, respectively, should be used. In high-risk patients, triple combination therapy including a subcutaneous or intravenous prostacyclin analogue should be considered. For patients who suffer from PAH and significant cardiopulmonary comorbidities, initial monotherapy is recommended and the use of combination therapies should be considered on an individual basis. The latter recommendations are based on the scarcity of evidence supporting the use of combination therapy and the higher risk of drug-related adverse events in such patients. (c) 2018 Elsevier B.V. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hoeper, Marius M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Apitz, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Gruenig, Ekkehard UNSPECIFIED UNSPECIFIED UNSPECIFIED Halank, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Ewert, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaemmerer, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabitz, Hans-Joachim UNSPECIFIED orcid.org/0000-0002-0080-7125 UNSPECIFIED Kaehler, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Klose, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Leuchte, Hanno UNSPECIFIED UNSPECIFIED UNSPECIFIED Ulrich, Silvia UNSPECIFIED orcid.org/0000-0002-5250-5022 UNSPECIFIED Olsson, Karen M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Distler, Oliver UNSPECIFIED orcid.org/0000-0002-0546-8310 UNSPECIFIED Rosenkranz, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Ghofrani, H. Ardeschir UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-162572
DOI:	10.1016/j.ijcard.2018.08.082
Journal or Publication Title:	Int. J. Cardiol.
Volume:	272
Page Range:	S. 37 - 46
Date:	2018
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1874-1754
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ENDOTHELIN RECEPTOR ANTAGONIST; LONG-TERM EXTENSION; 5 INHIBITOR THERAPY; COMBINATION THERAPY; INTRAVENOUS EPOPROSTENOL; DOUBLE-BLIND; SILDENAFIL CITRATE; INHALED ILOPROST; POTTS SHUNT; DIFFUSION CAPACITY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16257