A very interesting article about epoprostenol, the first ever therapy to be approved for the treatment of pulmonary arterial hypertension. The development of epoprostenol followed on from the discovery of endogenous prostacyclins in the vasculature by Sir Salvator Moncada et al. in the 1970s. Shortly after this, epoprostenol was synthesised and shown to have anti-platelet activity and vasodilatory effects in humans. One of the first patients given epoprostenol was a young woman with idiopathic pulmonary hypertension. Intravenous epoprostenol improved haemodynamic parameters and clinical symptoms and the patient was discharged to continue long-term treatment (1984). Another early proof-of-concept study involving seven patients with idiopathic pulmonary arterial hypertension showed that epoprostenol increased cardiac output and reduced pulmonary arterial pressure (PAP) and pulmonary vascular resistance (PVR) (1982). These and other early explorations preceded the innovative clinical studies that led to the first approval of epoprostenol for the treatment of patients with idiopathic pulmonary hypertension in 1995.
The full text of the article can be viewed on the European Respiratory Review web page at this link
“Epoprostenol and pulmonary arterial hypertension: 20 years of clinical experience”, Olivier Sitbon, Anton Vonk Noordegraaf, European Respiratory Review 2017 26: 160055; DOI: 10.1183/16000617.0055-2016