An implantable pump Lenus pro® in the treatment of pulmonary arterial hypertension with intravenous treprostinil
Abstract Background Subcutaneous treprostinil is a prostacyclin analogue used to treat pulmonary arterial hypertension (PAH). Due to local pain it can cause a deterioration of heart related quality of life (HRQoL) or even abandonment of treatment. The aim of this paper was to assess the feasibility...
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doaj-2d19354a5ac942a198003378e379b3062020-11-24T21:03:59ZengBMCBMC Pulmonary Medicine1471-24662017-12-011711810.1186/s12890-017-0474-7An implantable pump Lenus pro® in the treatment of pulmonary arterial hypertension with intravenous treprostinilMarcin Kurzyna0Katarzyna Małaczyńska-Rajpold1Andrzej Koteja2Agnieszka Pawlak3Łukasz Chrzanowski4Michał Furdal5Zbigniew Gąsior6Wojciech Jacheć7Bożena Sobkowicz8Justyna Norwa9Tatiana Mularek-Kubzdela10Adam Torbicki11Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre Otwock1st Department of Cardiology, University of Medical SciencesDepartment of Anesthesiology and Intensive Care, European Health Centre OtwockDepartment of Invasive Cardiology, Central Clinical Hospital of the Ministry of the Interior and AdministrationDepartment of Cardiology, Medical University of LodzDepartment of Cardiology, Provincial Specialist Hospital in Wroclaw, Research and Development CentreDepartment of Cardiology, SHS, Medical University of Silesia2nd Department of Cardiology, School of Medicine with Dentistry Division, Medical University of SilesiaDepartment of Cardiology, Medical University of BialystokDepartment of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre Otwock1st Department of Cardiology, University of Medical SciencesDepartment of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre OtwockAbstract Background Subcutaneous treprostinil is a prostacyclin analogue used to treat pulmonary arterial hypertension (PAH). Due to local pain it can cause a deterioration of heart related quality of life (HRQoL) or even abandonment of treatment. The aim of this paper was to assess the feasibility of treatment with intravenous treprostinil administered by means of the Lenus Pro® implantable pump. Methods This was a retrospective, multi-center study involving 12 patients (8 females) with PAH treated with a subcutaneous infusion of treprostinil with intolerable pain at the infusion site. Clinical evaluation, including HRQoL assessment with SF-36 questionnaire was performed, before pump implantation and 2–9 months after. The median time of follow-up time was 14 months (4–29 months). Results After implantation of the Lenus Pro® pump, no statistically significant changes were observed in the 6-min walking distance and NT-proBNP. After implantation 50% of patients were in II WHO functional class (33% before, p = 0,59). There was a significant improvement in HRQoL within the Physical Component Score (28 ± 7 vs 38 ± 8 pts., p < 0,001) and in specific domains of SF-36 form: physical role (31 ± 7 pts. vs. 41 ± 12 pts., p = 0,03), bodily pain (31 ± 12 vs. 50 ± 14 pts., p = 0,02), and vitality (37 ± 8 pts. vs. 50 ± 14 pts., p = 0,03). During the periprocedural period, one patient developed a recurrent haematoma at the implantation site. During follow-up in one patient, the drug delivering cannula slipped out of the subclavian vein, what required repositioning repeated twice, and in another patient an unexpected increase in the drug administration rate was observed. Conclusions In patients with PAH who do not tolerate subcutaneous infusion of treprostinil, the use of the Lenus Pro® implantable pump results in significant subjective improvement of vitality and physical aspect of the HRQoL with acceptable safety profile.http://link.springer.com/article/10.1186/s12890-017-0474-7Pulmonary arterial hypertensionTreprostinilImplantable pumpQuality of lifeSF-36 form |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Marcin Kurzyna Katarzyna Małaczyńska-Rajpold Andrzej Koteja Agnieszka Pawlak Łukasz Chrzanowski Michał Furdal Zbigniew Gąsior Wojciech Jacheć Bożena Sobkowicz Justyna Norwa Tatiana Mularek-Kubzdela Adam Torbicki |
spellingShingle |
Marcin Kurzyna Katarzyna Małaczyńska-Rajpold Andrzej Koteja Agnieszka Pawlak Łukasz Chrzanowski Michał Furdal Zbigniew Gąsior Wojciech Jacheć Bożena Sobkowicz Justyna Norwa Tatiana Mularek-Kubzdela Adam Torbicki An implantable pump Lenus pro® in the treatment of pulmonary arterial hypertension with intravenous treprostinil BMC Pulmonary Medicine Pulmonary arterial hypertension Treprostinil Implantable pump Quality of life SF-36 form |
author_facet |
Marcin Kurzyna Katarzyna Małaczyńska-Rajpold Andrzej Koteja Agnieszka Pawlak Łukasz Chrzanowski Michał Furdal Zbigniew Gąsior Wojciech Jacheć Bożena Sobkowicz Justyna Norwa Tatiana Mularek-Kubzdela Adam Torbicki |
author_sort |
Marcin Kurzyna |
title |
An implantable pump Lenus pro® in the treatment of pulmonary arterial hypertension with intravenous treprostinil |
title_short |
An implantable pump Lenus pro® in the treatment of pulmonary arterial hypertension with intravenous treprostinil |
title_full |
An implantable pump Lenus pro® in the treatment of pulmonary arterial hypertension with intravenous treprostinil |
title_fullStr |
An implantable pump Lenus pro® in the treatment of pulmonary arterial hypertension with intravenous treprostinil |
title_full_unstemmed |
An implantable pump Lenus pro® in the treatment of pulmonary arterial hypertension with intravenous treprostinil |
title_sort |
implantable pump lenus pro® in the treatment of pulmonary arterial hypertension with intravenous treprostinil |
publisher |
BMC |
series |
BMC Pulmonary Medicine |
issn |
1471-2466 |
publishDate |
2017-12-01 |
description |
Abstract Background Subcutaneous treprostinil is a prostacyclin analogue used to treat pulmonary arterial hypertension (PAH). Due to local pain it can cause a deterioration of heart related quality of life (HRQoL) or even abandonment of treatment. The aim of this paper was to assess the feasibility of treatment with intravenous treprostinil administered by means of the Lenus Pro® implantable pump. Methods This was a retrospective, multi-center study involving 12 patients (8 females) with PAH treated with a subcutaneous infusion of treprostinil with intolerable pain at the infusion site. Clinical evaluation, including HRQoL assessment with SF-36 questionnaire was performed, before pump implantation and 2–9 months after. The median time of follow-up time was 14 months (4–29 months). Results After implantation of the Lenus Pro® pump, no statistically significant changes were observed in the 6-min walking distance and NT-proBNP. After implantation 50% of patients were in II WHO functional class (33% before, p = 0,59). There was a significant improvement in HRQoL within the Physical Component Score (28 ± 7 vs 38 ± 8 pts., p < 0,001) and in specific domains of SF-36 form: physical role (31 ± 7 pts. vs. 41 ± 12 pts., p = 0,03), bodily pain (31 ± 12 vs. 50 ± 14 pts., p = 0,02), and vitality (37 ± 8 pts. vs. 50 ± 14 pts., p = 0,03). During the periprocedural period, one patient developed a recurrent haematoma at the implantation site. During follow-up in one patient, the drug delivering cannula slipped out of the subclavian vein, what required repositioning repeated twice, and in another patient an unexpected increase in the drug administration rate was observed. Conclusions In patients with PAH who do not tolerate subcutaneous infusion of treprostinil, the use of the Lenus Pro® implantable pump results in significant subjective improvement of vitality and physical aspect of the HRQoL with acceptable safety profile. |
topic |
Pulmonary arterial hypertension Treprostinil Implantable pump Quality of life SF-36 form |
url |
http://link.springer.com/article/10.1186/s12890-017-0474-7 |
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