The Medical Letter on Drugs and Therapeutics
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1488
Selexipag (Uptravi) for Pulmonary Arterial Hypertension
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The FDA has approved selexipag (Uptravi – Actelion), an oral selective prostacyclin IP receptor agonist, for treatment of pulmonary arterial hypertension (PAH). Treprostinil (Orenitram), an oral prostacyclin analog, was approved earlier for this indication.

STANDARD TREATMENT — Monotherapy with an oral drug is usually recommended for initial treatment of PAH (WHO functional class II or III). Drugs approved by the FDA for this indication include phosphodiesterase-5 (PDE5) inhibitors, endothelin receptor antagonists, and a guanylate cyclase stimulator (see Table 2). Patients with more advanced disease may be treated with a prostacyclin (epoprostenol, iloprost, or treprostinil). Current US guidelines recommend treatment with two or more classes of drugs only when the response is inadequate or the patient deteriorates on monotherapy, but a recent study found that first-line ... more      

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Title: Selexipag (Uptravi) for Pulmonary Arterial Hypertension
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