This review, published on Expert Opinion on Pharmacotherapy on March 19, 2025, chronicles the evolution of pulmonary arterial hypertension (PAH) treatment from historical milestones to current challenges. Beginning with Ernst von Romberg’s first clinical description in 1891 and the advent of cardiac catheterization, pulmonary arterial hypertension diagnosis and treatment have advanced significantly in past decades. Current approved therapies include prostacyclin analogs, PDE5 inhibitors, and endothelin receptor antagonists, which improve symptoms and hemodynamics but have limited impact on mortality. The authors highlight key limitations: most therapies focus mainly on vasodilation, benefiting only certain patients, treatments often involve high costs and complex administration, and the low prevalence of the disease and difficulties in clinical trial design have hindered the development of new therapies.
The authors conclude that “these challenges underscore the urgent need for translational research to optimize trial methodologies, accelerating the development of new therapies. Innovative approaches, such as drug repositioning and the exploration of novel molecular targets, are critical to overcoming these barriers and ensuring timely, effective, and affordable treatment options for patients with pulmonary arterial hypertension”.
Read more at this link on Expert Opinion on pharmacotherapy (full article available only on request)
Citation
Benavides-Córdoba, V., Palacios, M., & Vonk-Noordegraaf, A. (2025). Historical milestones and future horizons: exploring the diagnosis and treatment evolution of the pulmonary arterial hypertension in adults. Expert Opinion on Pharmacotherapy, 1–11. https://doi.org/10.1080/14656566.2025.2480764
See also our article on the history of pulmonary hypertension science at this link