Evidence map›Paper›PMID 41579242›Full record

ReviewAdvances in therapy2026

Advances in and Clinical Experience with Subcutaneous Infusion Pump Therapy for Pulmonary Arterial Hypertension.

Valerie LaRoy, Eric Roberts, Jennalyn Mayeux, Natalie Patzlaff, Reem Ismail, Kari Roberts, Lori Reed, Traci Stewart, Mary Whittenhall, Melisa Wilson

Abstract readReview
In one paragraph

Review in Advances in therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Valerie LaRoyPulmonary Hypertension Program, Advocate Christ Medical Center, 4440 West 95th Street, Oak Lawn, IL, USA.
Eric RobertsAdvanced Heart Failure and Transplant Cardiology, Aurora Health Care, 2900 West Oklahoma Avenue, Milwaukee, WI, USA.
Jennalyn MayeuxPulmonary Division, University of Utah, 1280 Stringham Avenue, Salt Lake City, UT, USA.
Natalie PatzlaffGlobal Medical Affairs, United Therapeutics, 55 TW Alexander Drive, Research Triangle Park, Durham, NC, USA.
Reem IsmailGlobal Medical Affairs, United Therapeutics, 55 TW Alexander Drive, Research Triangle Park, Durham, NC, USA.
Kari RobertsGlobal Medical Affairs, United Therapeutics, 55 TW Alexander Drive, Research Triangle Park, Durham, NC, USA.
Lori ReedPulmonology, Piedmont Healthcare, 275 Collier Road Northwest, Atlanta, GA, USA.
Traci StewartAdvanced Heart and Lung Program, University of Iowa, 200 Hawkins Drive, Iowa City, IA, USA.
Mary WhittenhallPulmonology, Pulmonary and Sleep Medicine Associates, 73 Highland Avenue, E. Providence, RI, USA.
Melisa WilsonAdvanced Lung Disease, AdventHealth Orlando, 601 E. Rollins St, Orlando, FL, USA. Melisa.Wilson@AdventHealth.com.ORCID 0000-0003-3359-0871

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pulmonary arterial hypertension (PAH) is characterized by progressive pulmonary vascular remodeling and a deficiency of endogenous prostacyclin, a potent vasodilator with antiproliferative effects. Prostacyclin analogues (PCAs) target this deficiency and are integral to the PAH treatment algorithm. Parenteral PCA therapy is recommended for patients at intermediate-high and high risk, and early initiation-particularly in combination regimens-is associated with improved survival in real-world and post hoc analyses.The 2002 approval of the parenteral PCA treprostinil (Remodulin®) marked a significant advancement in PCA therapy. Compared with epoprostenol, treprostinil offers greater chemical stability at room temperature and a longer half-life, enabling subcutaneous (SC) infusion and minimizing the complications and challenges associated with intravenous delivery. Despite robust evidence demonstrating its benefits on morbidity and mortality and risk-based guideline recommendations, parenteral PCA therapy remains underutilized. Contributing factors include concerns about the complexity and perceived burden of pump-based delivery systems.Here we review the place for parenteral prostacyclin in PAH therapy, and the evolution of SC PCA pumps over time, with a focus on recent enhancements intended to overcome practical limitations of older devices and thereby improve usability. Key features such as simplified cassette filling, automated priming, a larger and more intuitive touchscreen remote, and expanded flow rate options aim to reduce the perceived challenges of SC therapy and support broader adoption among patients and prescribers. The article also provides perspectives and practical guidance from experienced practitioners on the initiation and maintenance of SC PCA therapy, emphasizing how improvements in pump technology can help overcome barriers to use. Addressing these challenges through improved design, education, and support may help bridge the gap between evidence-based recommendations and real-world practice.Graphical abstract available for this article.

Indexed as

Antihypertensive AgentsEpoprostenolHypertension, PulmonaryPulmonary Arterial HypertensionHumansInfusion PumpsInfusions, SubcutaneousAntihypertensive AgentsEpoprostenoltreprostinilProstacyclin analoguePulmonary arterial hypertensionRemunityPROTreprostinil

Identifiers

PMID41579242
PMCPMC12999882

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.