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. 2017 Jul-Sep;7(3):702-711.
doi: 10.1177/2045893217721695. Epub 2017 Aug 22.

Recommendations for the clinical management of patients receiving macitentan for pulmonary arterial hypertension (PAH): A Delphi consensus document

Franck F Rahaghi  1 , Hassan M Alnuaimat  2 , Rana L A Awdish  3 , Vijay P Balasubramanian  4 , Robert C Bourge  5 , Charles D Burger  6 , John Butler  7 , C Gregory Cauthen  8 , Murali M Chakinala  9 , Bennett P deBoisblanc  10 , Michael S Eggert  11 , Peter Engel  12 , Jeremy Feldman  13 , J Wesley McConnell  14 , Myung Park  15 , Jeffrey S Sager  16 , Namita Sood  17 , Harold I Palevsky  18
Affiliations

Recommendations for the clinical management of patients receiving macitentan for pulmonary arterial hypertension (PAH): A Delphi consensus document

Franck F Rahaghi et al. Pulm Circ. 2017 Jul-Sep.

Abstract

In patients treated with macitentan (Opsumit®, Actelion Pharmaceuticals Ltd., Basel, Switzerland) for pulmonary arterial hypertension (PAH), prevention and/or effective management of treatment-related adverse events may improve adherence. However, management of these adverse events can be challenging and the base of evidence and clinical experience for macitentan is limited. In the absence of evidence, consensus recommendations from physicians experienced in using macitentan to treat PAH may benefit patients and physicians who are using macitentan. Consensus recommendations were developed by a panel of physicians experienced with macitentan and PAH using a modified Delphi process. Over three iterations, panelists developed and refined a series of statements on the use of macitentan in PAH and rated their agreement with each statement on a Likert scale. The panel of 18 physicians participated and developed a total of 118 statements on special populations, add-on therapy, drug-drug interactions, warnings and precautions, hospitalization and functional class, and adverse event management. The resulting consensus recommendations are intended to provide practical guidance on real-world issues in using macitentan to treat patients with PAH.

Keywords: adverse events; endothelin receptor antagonist; therapy adherence.

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Figures

Fig. 1.
Fig. 1.
The Delphi process used in the study.
Fig. 2.
Fig. 2.
The Likert scale used in the final stage of the Delphi process.
Fig. 3.
Fig. 3.
Delphi consensus results—special patient populations. Recommendations that achieved consensus are in bold.
Fig. 4.
Fig. 4.
Delphi consensus results—use of add-on therapy, “What is your opinion of co-administering macitentan with other PAH therapies?” Recommendations that achieved consensus are in bold.
Fig. 5.
Fig. 5.
Delphi consensus results—drug–drug interactions. Recommendations that achieved consensus are in bold.
Fig. 6.
Fig. 6.
Delphi consensus results—warnings and precautions. Recommendations that achieved consensus are in bold.
Fig. 7.
Fig. 7.
Delphi consensus results—hospitalization. Recommendations that achieved consensus are in bold.
Fig. 8.
Fig. 8.
Delphi consensus results—adverse events frequency and management.
See this image and copyright information in PMC

References

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