Pharmacologic therapy for pulmonary arterial hypertension in adults: CHEST guideline and expert panel report

Darren B. Taichman, Joe Ornelas, Lorinda Chung, James R. Klinger, Sandra Lewis, Jess Mandel, Harold I. Palevsky, Stuart Rich, Namita Sood, Erika B. Rosenzweig, Terence K. Trow, Rex Yung, C. Gregory Elliott, David B. Badesch

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Choices of pharmacologic therapies for pulmonary arterial hypertension (PAH) are ideally guided by high-level evidence. The objective of this guideline is to provide clinicians advice regarding pharmacologic therapy for adult patients with PAH as informed by available evidence. METHODS: This guideline was based on systematic reviews of English language evidence published between 1990 and November 2013, identified using the MEDLINE and Cochrane Library databases. The strength of available evidence was graded using the Grades of Recommendations, Assessment, Development, and Evaluation methodology. Guideline recommendations, or consensus statements when available evidence was insufficient to support recommendations, were developed using a modified Delphi technique to achieve consensus. RESULTS: Available evidence is limited in its ability to support high-level recommendations. Therefore, we draft ed consensus statements to address many clinical questions regarding pharmacotherapy for patients with PAH. A total of 79 recommendations or consensus statements were adopted and graded. CONCLUSIONS: Clinical decisions regarding pharmacotherapy for PAH should be guided by high-level recommendations when sufficient evidence is available. Absent higher level evidence, consensus statements based upon available information must be used. Further studies are needed to address the gaps in available knowledge regarding optimal pharmacotherapy for PAH.

Original languageEnglish (US)
Pages (from-to)449-475
Number of pages27
JournalChest
Volume146
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Pulmonary Hypertension
Consensus
Guidelines
Drug Therapy
Delphi Technique
Therapeutics
Aptitude
MEDLINE
Libraries
Language
Databases

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Taichman, D. B., Ornelas, J., Chung, L., Klinger, J. R., Lewis, S., Mandel, J., ... Badesch, D. B. (2014). Pharmacologic therapy for pulmonary arterial hypertension in adults: CHEST guideline and expert panel report. Chest, 146(2), 449-475. https://doi.org/10.1378/chest.14-0793

Pharmacologic therapy for pulmonary arterial hypertension in adults : CHEST guideline and expert panel report. / Taichman, Darren B.; Ornelas, Joe; Chung, Lorinda; Klinger, James R.; Lewis, Sandra; Mandel, Jess; Palevsky, Harold I.; Rich, Stuart; Sood, Namita; Rosenzweig, Erika B.; Trow, Terence K.; Yung, Rex; Elliott, C. Gregory; Badesch, David B.

In: Chest, Vol. 146, No. 2, 2014, p. 449-475.

Research output: Contribution to journalArticle

Taichman, DB, Ornelas, J, Chung, L, Klinger, JR, Lewis, S, Mandel, J, Palevsky, HI, Rich, S, Sood, N, Rosenzweig, EB, Trow, TK, Yung, R, Elliott, CG & Badesch, DB 2014, 'Pharmacologic therapy for pulmonary arterial hypertension in adults: CHEST guideline and expert panel report', Chest, vol. 146, no. 2, pp. 449-475. https://doi.org/10.1378/chest.14-0793
Taichman, Darren B. ; Ornelas, Joe ; Chung, Lorinda ; Klinger, James R. ; Lewis, Sandra ; Mandel, Jess ; Palevsky, Harold I. ; Rich, Stuart ; Sood, Namita ; Rosenzweig, Erika B. ; Trow, Terence K. ; Yung, Rex ; Elliott, C. Gregory ; Badesch, David B. / Pharmacologic therapy for pulmonary arterial hypertension in adults : CHEST guideline and expert panel report. In: Chest. 2014 ; Vol. 146, No. 2. pp. 449-475.
@article{a1c6389709f64637b477724e700968c3,
title = "Pharmacologic therapy for pulmonary arterial hypertension in adults: CHEST guideline and expert panel report",
abstract = "OBJECTIVE: Choices of pharmacologic therapies for pulmonary arterial hypertension (PAH) are ideally guided by high-level evidence. The objective of this guideline is to provide clinicians advice regarding pharmacologic therapy for adult patients with PAH as informed by available evidence. METHODS: This guideline was based on systematic reviews of English language evidence published between 1990 and November 2013, identified using the MEDLINE and Cochrane Library databases. The strength of available evidence was graded using the Grades of Recommendations, Assessment, Development, and Evaluation methodology. Guideline recommendations, or consensus statements when available evidence was insufficient to support recommendations, were developed using a modified Delphi technique to achieve consensus. RESULTS: Available evidence is limited in its ability to support high-level recommendations. Therefore, we draft ed consensus statements to address many clinical questions regarding pharmacotherapy for patients with PAH. A total of 79 recommendations or consensus statements were adopted and graded. CONCLUSIONS: Clinical decisions regarding pharmacotherapy for PAH should be guided by high-level recommendations when sufficient evidence is available. Absent higher level evidence, consensus statements based upon available information must be used. Further studies are needed to address the gaps in available knowledge regarding optimal pharmacotherapy for PAH.",
author = "Taichman, {Darren B.} and Joe Ornelas and Lorinda Chung and Klinger, {James R.} and Sandra Lewis and Jess Mandel and Palevsky, {Harold I.} and Stuart Rich and Namita Sood and Rosenzweig, {Erika B.} and Trow, {Terence K.} and Rex Yung and Elliott, {C. Gregory} and Badesch, {David B.}",
year = "2014",
doi = "10.1378/chest.14-0793",
language = "English (US)",
volume = "146",
pages = "449--475",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "2",

}

TY - JOUR

T1 - Pharmacologic therapy for pulmonary arterial hypertension in adults

T2 - CHEST guideline and expert panel report

AU - Taichman, Darren B.

AU - Ornelas, Joe

AU - Chung, Lorinda

AU - Klinger, James R.

AU - Lewis, Sandra

AU - Mandel, Jess

AU - Palevsky, Harold I.

AU - Rich, Stuart

AU - Sood, Namita

AU - Rosenzweig, Erika B.

AU - Trow, Terence K.

AU - Yung, Rex

AU - Elliott, C. Gregory

AU - Badesch, David B.

PY - 2014

Y1 - 2014

N2 - OBJECTIVE: Choices of pharmacologic therapies for pulmonary arterial hypertension (PAH) are ideally guided by high-level evidence. The objective of this guideline is to provide clinicians advice regarding pharmacologic therapy for adult patients with PAH as informed by available evidence. METHODS: This guideline was based on systematic reviews of English language evidence published between 1990 and November 2013, identified using the MEDLINE and Cochrane Library databases. The strength of available evidence was graded using the Grades of Recommendations, Assessment, Development, and Evaluation methodology. Guideline recommendations, or consensus statements when available evidence was insufficient to support recommendations, were developed using a modified Delphi technique to achieve consensus. RESULTS: Available evidence is limited in its ability to support high-level recommendations. Therefore, we draft ed consensus statements to address many clinical questions regarding pharmacotherapy for patients with PAH. A total of 79 recommendations or consensus statements were adopted and graded. CONCLUSIONS: Clinical decisions regarding pharmacotherapy for PAH should be guided by high-level recommendations when sufficient evidence is available. Absent higher level evidence, consensus statements based upon available information must be used. Further studies are needed to address the gaps in available knowledge regarding optimal pharmacotherapy for PAH.

AB - OBJECTIVE: Choices of pharmacologic therapies for pulmonary arterial hypertension (PAH) are ideally guided by high-level evidence. The objective of this guideline is to provide clinicians advice regarding pharmacologic therapy for adult patients with PAH as informed by available evidence. METHODS: This guideline was based on systematic reviews of English language evidence published between 1990 and November 2013, identified using the MEDLINE and Cochrane Library databases. The strength of available evidence was graded using the Grades of Recommendations, Assessment, Development, and Evaluation methodology. Guideline recommendations, or consensus statements when available evidence was insufficient to support recommendations, were developed using a modified Delphi technique to achieve consensus. RESULTS: Available evidence is limited in its ability to support high-level recommendations. Therefore, we draft ed consensus statements to address many clinical questions regarding pharmacotherapy for patients with PAH. A total of 79 recommendations or consensus statements were adopted and graded. CONCLUSIONS: Clinical decisions regarding pharmacotherapy for PAH should be guided by high-level recommendations when sufficient evidence is available. Absent higher level evidence, consensus statements based upon available information must be used. Further studies are needed to address the gaps in available knowledge regarding optimal pharmacotherapy for PAH.

UR - http://www.scopus.com/inward/record.url?scp=84905654511&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84905654511&partnerID=8YFLogxK

U2 - 10.1378/chest.14-0793

DO - 10.1378/chest.14-0793

M3 - Article

C2 - 24937180

AN - SCOPUS:84905654511

VL - 146

SP - 449

EP - 475

JO - Chest

JF - Chest

SN - 0012-3692

IS - 2

ER -