{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T18:08:31Z","timestamp":1770919711603,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,6,30]],"date-time":"2017-06-30T00:00:00Z","timestamp":1498780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:p>Chronic thromboembolic pulmonary hypertension (<jats:styled-content style=\"fixed-case\">CTEPH<\/jats:styled-content>) occurs when pulmonary emboli fail to resolve with anticoagulation. For patients with inoperable or residual <jats:styled-content style=\"fixed-case\">CTEPH<\/jats:styled-content>, riociguat is currently the only therapy approved by the United States Food and Drug Administration. However, some patients with <jats:styled-content style=\"fixed-case\">CTEPH<\/jats:styled-content> may require therapy beyond riociguat, such as intravenous prostacyclins, which can present significant administration challenges in patients with complex comorbid conditions. We describe a 42\u2010year\u2010old man with T12 paraplegia complicated by <jats:styled-content style=\"fixed-case\">CTEPH<\/jats:styled-content> (functional class <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> with substantial right ventricular dysfunction) and severe pressure ulcers. In order to facilitate goals of care (hospital discharge to a skilled nursing facility where parenteral prostanoids could not be administered), he underwent rapid transition from intravenous treprostinil to oral selexipag in the form of a cross\u2010taper over 6 days. The patient required readmission due to worsening symptoms and was transitioned back to intravenous treprostinil; he tolerated conversion to oral treprostinil for approximately 4 months, but it was subsequently discontinued due to nausea and modified goals of care. The patient underwent transition to hospice care 3 months later and eventually died from clinical deterioration. To our knowledge, this is the first report to describe transition from intravenous treprostinil to selexipag as well as conversion from parenteral treprostinil to oral treprostinil in a patient with <jats:styled-content style=\"fixed-case\">CTEPH<\/jats:styled-content> and illustrates the approaches to and potential issues with prostanoid transitions. Additional observations are necessary to better understand the relative roles of selexipag and oral treprostinil regarding comparative efficacy and tolerability.<\/jats:p>","DOI":"10.1002\/phar.1951","type":"journal-article","created":{"date-parts":[[2017,5,17]],"date-time":"2017-05-17T10:52:51Z","timestamp":1495018371000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Transition of Intravenous Treprostinil to Oral Therapy in a Patient with Functional Class <scp>IV<\/scp> Chronic Thromboembolic Pulmonary Hypertension"],"prefix":"10.1002","volume":"37","author":[{"given":"Kristina M.","family":"Thurber","sequence":"first","affiliation":[{"name":"Hospital Pharmacy Services Mayo Clinic Rochester Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Breann M.","family":"Williams","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy Services Mayo Clinic Rochester Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth E.","family":"Bates","sequence":"additional","affiliation":[{"name":"Hospital Internal Medicine Mayo Clinic Rochester Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert P.","family":"Frantz","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases Mayo Clinic Rochester Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,6,30]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1209657"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-0793"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01032-2015"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40256-015-0117-4"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1086\/685111"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/2045-8932.109926"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.07.012"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1503184"},{"key":"e_1_2_5_10_1","volume-title":"Uptravi (selexipag) package insert","author":"Actelion Pharmaceuticals","year":"2015"},{"key":"e_1_2_5_11_1","volume-title":"Orenitram (treprostinil) package insert","author":"United Therapeutics Corp","year":"2016"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.124388"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-2875"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2212"},{"key":"e_1_2_5_15_1","unstructured":"SitbonO ChannickR ChinKM et al.Protocol Supplementary File for Selexipag for the Treatment of Pulmonary Arterial Hypertension. Available fromhttps:\/\/www.nejm.org\/doi\/suppl\/10.1056\/nejmoa1503184\/suppl_file\/nejmoa1503184_protocol.pdf. Accessed October 7 2016."}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fphar.1951","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.1951","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T11:53:08Z","timestamp":1761047588000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.1951"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,30]]},"references-count":14,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2017,8]]}},"alternative-id":["10.1002\/phar.1951"],"URL":"https:\/\/doi.org\/10.1002\/phar.1951","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6,30]]},"assertion":[{"value":"2017-06-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}