Treatment Advancements

The understanding of pulmonary arterial hypertension (PAH) and the number of treatment options has grown over the past two decades. PAH-specific treatment has advanced from one treatment approved in 1996, to nine FDA-approved treatment options available today, with many more in clinical development. Every advancement towards better diagnostic tools and treatment may offer new hope for people living with PAH.

Three Treatment Pathways of PAH

Prostacyclin, endothelin and nitric oxide are three chemicals that are naturally produced in the body. When the levels of these chemicals become imbalanced, it can cause the blood vessels—specifically those in the lungs—to narrow, leading to PAH.

Three types of medicine are approved to treat PAH:

Prostanoids
PDE-5 inhibitors (Phosphodiesterase-5 inhibitors)
ETRAs (Endothelin receptor antagonists)

These treatments work to dilate (open) blood vessels, making it easier for the heart to pump blood to the lungs.

Treatment Pathways

Prostanoid Therapy Is One of Three PAH Treatment Pathways

Prostacyclin is a substance that is naturally present in the body and helps keep blood vessels open and working properly. People with PAH often have lower levels of this substance. Prostanoids help compensate for some of the effects of the natural prostacyclin that is missing.

Prostanoids:

Are an established treatment option for PAH
Are the first class of medicine to be approved specifically to treat PAH
Mimic the action of prostacyclin, a substance naturally produced by the body to help keep blood vessels open and working properly

Indication

Tyvaso is a prescription medicine used in adults to treat pulmonary arterial hypertension (PAH) (WHO Group 1), which is high blood pressure in the arteries of your lungs. Tyvaso can improve exercise ability in people who also take bosentan (an endothelin receptor antagonist) or sildenafil (a phosphodiesterase-5 inhibitor). The effects decrease over 4 hours; treatment timing can be adjusted for planned activities.

Studies establishing effectiveness included predominately patients with NYHA Functional Class III symptoms and etiologies of idiopathic or heritable PAH (56%) or PAH associated with connective tissue diseases (33%).

Important Safety Information for Tyvaso

Tyvaso is breathed in (inhalable) through your mouth into your lungs. Tyvaso should only be used with the Tyvaso Inhalation System
The effects of Tyvaso are unknown in patients with lung disease (such as asthma or chronic obstructive pulmonary disease) and in patients under 18 years of age
If you have low blood pressure, Tyvaso may cause symptomatic hypotension (low blood pressure)
Because Tyvaso reduces the ability of your blood to clot (coagulate), it may increase your risk for bleeding if you are taking blood thinners (anticoagulants), such as warfarin or heparin
The use of Tyvaso with diuretics (water pills), antihypertensives (medications used to treat high blood pressure or heart disease), or other vasodilators (medications that lower blood pressure) may increase your risk for hypotension (low blood pressure)

Other medical conditions and medicines may affect your use of Tyvaso by increasing the risk of side effects or decreasing effectiveness. It is important to tell your doctor about your medical conditions and any medicines you may be taking, including:

If you are taking gemfibrozil (for high cholesterol) or rifampin (for infection), your Tyvaso dosage may need adjustment
If you have liver or kidney problems, your ability to tolerate Tyvaso may be affected
If you are pregnant, breast-feeding, or planning to become pregnant, talk with your healthcare provider about whether you should take Tyvaso

The most common side effects of Tyvaso are coughing, headache, throat irritation and pain, nausea, reddening of the face and neck (flushing), and fainting or loss of consciousness. These are not all the possible side effects of Tyvaso. Tell your doctor about any side effects that bother you or do not go away. Your doctor may be able to help you manage the side effects.

For more information about Tyvaso, please see the Full Prescribing Information, Patient Package Insert, and the Tyvaso Inhalation System Instructions for Use Manual. Questions? Call the Customer Service Line at 1-877-UNITHER (1-877-864-8437).