{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:16:07Z","timestamp":1787019367914,"version":"build-2736575974"},"reference-count":52,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,4,1]],"date-time":"2017-04-01T00:00:00Z","timestamp":1491004800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2017,4,1]],"date-time":"2017-04-01T00:00:00Z","timestamp":1491004800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Pulm. circ."],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:p>Pulmonary arterial hypertension (PAH) is a progressive potentially fatal disease. Multiple pharmacologic options are now available, which facilitated transitions between different therapeutic options, although the evidence for such transitions has not been well described. We sought to review the evidence supporting the safety and\/or efficacy of transitioning between PAH\u2010specific medications. We performed a systematic review of all published studies in the Medline database between 1\u00a0January 2000 and 30\u00a0June 2016 reporting on any transition between the currently Food and Drug Administration (FDA)\u2010approved PAH\u2010specific medications. Studies reporting on three or more adult patients published in the English language reporting on transitions between FDA\u2010approved PAH medications were extracted and tabulated. Forty\u2010one studies met the selection criteria, nine of which included less than eight patients (and thus were reported separately in the supplement), for a total of 32 studies. Transitioning from parenteral epoprostenol to parenteral treprostinil appears to be safe and efficacious in patients who have less severe disease and more favorable hemodynamics. Transitioning from a prostacyclin analogue to an oral medication may be successful in patients who have favorable hemodynamics and stable disease. There is conflicting evidence supporting the transition from a parenteral to an inhaled prostacyclin analogue, even in patients who are on background oral therapy. Currently, the only evidence in support of transitioning between oral PDE5\u00a0inhibitors is from sildenafil to tadalafil. Patients on higher doses of sildenafil are more likely to fail. In patients with liver abnormalities due to bosentan or sitaxentan, the transition to ambrisentan appears to be safe and can result in clinical improvement. Studies regarding PAH medication transitions are limited. Patients who have less severe disease, better functional status, and are on lower medications doses may be more successful at transitioning.<\/jats:p>","DOI":"10.1177\/2045893217706357","type":"journal-article","created":{"date-parts":[[2017,4,4]],"date-time":"2017-04-04T17:05:51Z","timestamp":1491325551000},"page":"326-338","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["A systematic review of transition studies of pulmonary arterial hypertension specific medications"],"prefix":"10.1002","volume":"7","author":[{"given":"Avraham","family":"Sofer","sequence":"first","affiliation":[{"name":"Section of Pulmonary, Critical Care &amp; Sleep Medicine Department of Internal Medicine Yale University New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Ryan","sequence":"additional","affiliation":[{"name":"French Hospital Medical Center San Luis Obispo CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan J.","family":"Tedford","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel A.","family":"Wirth","sequence":"additional","affiliation":[{"name":"Tufts University, Boston MA &amp; Maine Medical Center Portland ME USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wassim H.","family":"Fares","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Critical Care &amp; Sleep Medicine Department of Internal Medicine Yale University New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-0676"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-115-5-343"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.10.023"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01032-2015"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.10.031"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/FJC.0000000000000375"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1503184"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.08.010"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.4103\/2045-8932.114768"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199602013340504"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.06-2118"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.129.6.1636"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-1004"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.06.008"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.12170"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.07.012"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.06.019"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1086\/685111"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/1755-5922.12008"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2007.07.040"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951106000114"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-012-9408-6"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-014-9657-7"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-1028"},{"key":"e_1_2_8_27_1","unstructured":"ClinicalTrials.gov. 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