{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:41:20Z","timestamp":1786977680486,"version":"build-2736575974"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":877,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Intravenous (i.v.) prostacyclin is the cornerstone treatment in high-risk pulmonary arterial hypertension (PAH) patients. Selexipag is an orally available prostacyclin receptor agonist. Limited data are available regarding the feasibility of transitioning from i.v. epoprostenol to selexipag. A 50-year-old woman with idiopathic PAH was diagnosed in a World Health Organization (WHO) Functional Class (FC) IV. She improved with upfront triple combination therapy, including i.v. epoprostenol. Over 2 years of follow-up, the patient remained at low risk and expressed strong preference towards oral therapies. After careful risk\u2013benefit clinical consideration, she was transitioned from i.v. epoprostenol to selexipag. Selexipag was started at dosage of 200 \u03bcg twice daily (b.i.d.) and titrated up to 1600 \u03bcg b.i.d. over 8 weeks (up-titration of 200 \u03bcg b.i.d. every week). Simultaneously, i.v. epoprostenol was down-titrated 3.0 ng\/kg\/min every week from a dosage of 27.5 ng\/kg\/min. The transition occurred under strict medical surveillance and was well tolerated. One year after discontinuation of epoprostenol, the patient remains in WHO FC I and has no signs of clinical deterioration. Although not generalizable to most PAH patients, this case highlights that a carefully planned transition from epoprostenol to selexipag is feasible in selected low-risk patients within a shared medical decision-making framework.<\/jats:p>","DOI":"10.1002\/ehf2.14428","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T20:23:31Z","timestamp":1687206211000},"page":"2722-2727","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Transitioning Intravenous Epoprostenol to Oral Selexipag in Idiopathic Pulmonary Arterial Hypertension: A Case Report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2465-2217","authenticated-orcid":false,"given":"Andr\u00e9","family":"Alexandre","sequence":"first","affiliation":[{"name":"Department of Cardiology, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio (CHUdSA) , Porto ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3985-0718","authenticated-orcid":false,"given":"In\u00eas","family":"Furtado","sequence":"additional","affiliation":[{"name":"Pulmonary Vascular Disease Unit, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio (CHUdSA) , Porto ,","place":["Portugal"]},{"name":"Department of Internal Medicine, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio (CHUdSA) , Porto ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu\u00edsa","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Pulmonary Vascular Disease Unit, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio (CHUdSA) , Porto ,","place":["Portugal"]},{"name":"Department of Internal Medicine, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio (CHUdSA) , Porto ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3439-5093","authenticated-orcid":false,"given":"Fabienne","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Pulmonary Vascular Disease Unit, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio (CHUdSA) , Porto ,","place":["Portugal"]},{"name":"Department of Internal Medicine, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio (CHUdSA) , Porto ,","place":["Portugal"]},{"name":"ICBAS\u2014School of Medicine and Biomedical Sciences, University of Porto , Porto ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alzira","family":"Melo","sequence":"additional","affiliation":[{"name":"Pulmonary Vascular Disease Unit, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio (CHUdSA) , Porto ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana","family":"Alves","sequence":"additional","affiliation":[{"name":"Pulmonary Vascular Disease Unit, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio (CHUdSA) , Porto ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4509-0260","authenticated-orcid":false,"given":"M\u00e1rio","family":"Santos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio (CHUdSA) , Porto ,","place":["Portugal"]},{"name":"Pulmonary Vascular Disease Unit, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio (CHUdSA) , Porto ,","place":["Portugal"]},{"name":"ICBAS\u2014School of Medicine and Biomedical Sciences, University of Porto , Porto ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9932-3736","authenticated-orcid":false,"given":"Ab\u00edlio","family":"Reis","sequence":"additional","affiliation":[{"name":"Pulmonary Vascular Disease Unit, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio (CHUdSA) , Porto ,","place":["Portugal"]},{"name":"Department of Internal Medicine, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio (CHUdSA) , Porto ,","place":["Portugal"]},{"name":"ICBAS\u2014School of Medicine and Biomedical Sciences, University of Porto , Porto ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,6,19]]},"reference":[{"key":"2026012114093532400_ehf214428-bib-0001","doi-asserted-by":"crossref","first-page":"3618","DOI":"10.1093\/eurheartj\/ehac237","article-title":"2022 ESC\/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: developed by the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). 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