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Insuficiencia cardíaca

versión On-line ISSN 1852-3862


LOBO MARQUEZ¹, Lilia Luz  y  BEVACQUA², Raúl J.. Hipertensión arterial pulmonar: selexipag: Agonista selectivo del receptor de prostaciclina vía oral. Insuf. card. [online]. 2019, vol.14, n.1, pp.34-44. ISSN 1852-3862.

Pulmonary arterial hypertension (PAH) is a rare disease, but when it is not treated, it not only decreases the patient s quality of life, but also endangers their life. PAH is related to high levels of endothelin (ET 1) and reduced levels of nitric oxide (NO) and prostacyclin (PGI2). The specific therapeutic approaches of PAH focus on the different pathophysiologically directed pathways: the endothelin receptor (eg, bosentan), phosphodiesterase-5 (eg, sildenafil) or prostacyclin analogs (eg, treprostinil). Recently, the new drug selexipag, which acts as a selective agonist for the non-prostanoid IP2 receptor, has been approved for the treatment of PAH. Selexipag has a high selectivity for the IP2 receptor and differs from conventional prostacyclin analogs in its chemical structure. In the GRIPHON study it was shown that selexipag significantly improves the endpoint composed mainly of death or complications related to PAH (hazard ratio 0.6, 99% confidence interval, 0.46 to 0.78, P<0.001), as well as the ability to exercise by the 6-minute walk test. However, a significant reduction in mortality from all causes was not achieved. Selexipag has also shown promising results in combination therapy with phosphodiesterase-5 inhibitors and/or endothelin receptor antagonists. The most common side effects associated with selexipag are headache, diarrhea, jaw pain and nausea; although, during the GRIPHON study, it was generally well tolerated. Selexipag is a valuable addition to the therapy of PAH, especially by reducing the PAH-related hospitalizations and, therefore, improving the quality of life in PAH patients.

Palabras clave : Pulmonary arterial hypertension; Prostacyclin analogues; Non-prostanoid IP2 receptor agonists; Selexipag; Adverse effects.

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