Key result
Prostacyclin analogues differ in their antiplatelet effects, with epoprostenol and treprostinil potentially increasing bleeding risk, whereas iloprost, beraprost, and selexipag do not appear to increase bleeding tendency.
Why the study?
Prostacyclin analogues inhibit platelets in addition to causing vasodilation in PAH, but their antiplatelet effects and differences between agents are not thoroughly established.
Do different prostacyclin analogues have varying antiplatelet effects that impact the risk of thrombosis or bleeding in patients with pulmonary arterial hypertension?
Do different prostacyclin analogues have varying antiplatelet effects that impact the risk of thrombosis or bleeding in patients with pulmonary arterial hypertension?
This review highlights the clinical importance of considering the varying antiplatelet effects of different prostacyclin analogues when tailoring PAH therapy to individual patient bleeding and thrombotic risks.
May inform agent-specific bleeding risk assessment in PAH; leaves open need for prospective comparative trials.
Prostacyclin and analogues are successfully used in the treatment of pulmonary arterial hypertension (PAH) due to their vasodilatory effect on pulmonary arteries. Besides vasodilatory effect, prostacyclin analogues inhibit platelets, but their antiplatelet effect is not thoroughly established. The antiplatelet effect of prostacyclin analogues may be beneficial in case of increased risk of thromboembolic events, or undesirable in case of increased risk of bleeding. Since prostacyclin and analogues differ regarding their potency and form of administration, they might also inhibit platelets to a different extent. This review summarizes the recent evidence on the antiplatelet effects of prostacyclin and analogue in the treatment of PAH, this is important to consider when choosing the optimal treatment regimen in tailoring to an individual patients' needs.
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Rogula et al. (2020) conducted a review in Pulmonary arterial hypertension. Prostacyclin analogues was evaluated. Prostacyclin analogues differ in their antiplatelet effects, with epoprostenol and treprostinil potentially increasing bleeding risk, whereas iloprost, beraprost, and selexipag do not appear to increase bleeding tendency.
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