Title : Macitentan/Tadalafil Combination– An additional value in pharmacotherapy of pulmonary arterial hypertension
Abstract:
Pulmonary arterial hypertension (PAH) remains a devastating disease with high morbidity and mortality. It is uncommon, progressive and life-threatening blood vessel disorder differentiated by the constriction of minor pulmonary arteries and elevated blood pressure in the pulmonary circulation that in the end leads to right heart failure. The European Society of Cardiology / European Respiratory Society clinical guidelines recommend initial combination therapy of an endothelin receptor antagonist and a PDE5 inhibitor for patients with idiopathic PAH, heritable drug-associated PAH, or PAH-associated with connective tissue disease without cardiopulmonary comorbidities at low or intermediate risk. Since disease progresses rapidly for many patients, and frequently accompanied with serious clinical presentation, new pharmacological options continue to be needed. The new FDA-approved single-tablet combination of macitentan, an endothelin receptor antagonist, and tadalafil, a phosphodiesterase 5 (PDE5) inhibitor, is indicated for chronic treatment of PAH (WHO Group I) in adult patients of WHO functional class (FC) II-III. Individually, macitentan reduces the risk of clinical worsening events and hospitalization, and tadalafil improves exercise ability. It was suggested that this drug may offer a patient-friendly approach to support initial combination therapy and rapid escalation for the appropriate patients. In light of previous facts, the main objectives of this presentation will be to clarify the pharmacological properties of macitentan/tadalafil combination, including pharmacodynamics, pharmacokinetics, indications, and contraindications for use, adverse drug reactions, as well as the most important drug interactions. This will provide a better understanding of this additional drug for PAH, consequently helping clinicians in its suitable prescribing and adequate clinical use.
