We can learn a lot from you...

Transcription

1 Educational program by Material endorsed by We can learn a lot from you... When it comes to pulmonary arterial hypertension (PAH), the members of your specialist healthcare team are experts on the best s. But when it comes to how you feel, nobody can match your expertise. By properly understanding how well you are doing on your current for example, whether you are finding it more or less of a struggle when you are out and about your doctor may be able to adjust your medication so that it suits you better. Functional Classes & Treatment Options

2 Contents This is why it is important that at every step, your PH specialists have a clear picture of how you are doing. The more they know, the more they can help you get on with life and the things that matter to you. Page What is a WHO functional class description? Assessing the individual functional class The of Pulmonary Arterial Hypertension (PAH) Different types of PAH What are your options? What is the best for you? How do you feel? Treatment can be adjusted to suit you better 2

3 What is a WHO functional class description? Assessing the individual functional class The WHO functional class description is used to assess the severity of your PH and helps your healthcare team better understand how it s affecting you. CLASS I: CLASS II: CLASS III: CLASS IV: Symptom-free when physically active or resting Symptom-free when resting, but normal activities such as climbing the stairs, grocery shopping or making the bed may lead to discomfort and shortness of breath Resting may be symptom free, but doing normal chores around the house are greatly limited due to shortness of breath, or feeling tired. Symptoms at rest and severe symptoms with any activity aim of is to improve symptoms - ideally either getting people to, or keeping them in, WHO functional class I or II. 1 To help you achieve this: How would you describe your health status in general? When you walk alongside people of the same age, do you fall behind so that they have to wait for you? Do you have symptoms (e.g. breathlessness) during normal activities like washing, dressing and moving around the house? How many minutes can you walk for before needing a break? After how many flights of stairs do you feel breathless? Do you get breathless bending down to tie up your shoelaces? Is your disease preventing you from social activities e.g. going to the cinema or meeting friends? Are you still able to have a normal sexual relationship? How often do you feel down, depressed or hopeless?? When your PH healthcare team assigns you to a functional class and thus is assessing your disease state, they are going to talk about questions like these with you. Thinking about the answers in advance will help you to discuss your personal disease state with them. 3 It s really important that you take your medication as prescribed. Take note of how you're feeling and if you have found something easier or more difficult to do, write it down. How many times a week do you feel full of energy? 4

4 PAH Treatment aims to make your everyday life easier. Different s are available; the most appropriate for you will depend on various factors, which your pulmonary hypertension (PH) specialist team will discuss with you. Alice* Age 29, functional class (FC) II, recently diagnosed: I can t walk my dog anymore without stopping to catch my breath Paul* Age 62, FC III: I have to take breaks when cooking the family dinner because I am so tired and breathless Celine* Age 54, FC IV: Lately I get breathless just sitting and watching television Alice, Celine and Paul are PAH patients just like you. They re interested in the best possible PAH for themselves and wish to discuss the different options with their PH specialist. Read more about their stories on the following pages and learn more about your options. 5 *These patient cases are not real patient cases but fictive. 6

5 Four different types of are available specifically for pulmonary arterial hypertension (PAH), to help blood flow more easily through your lungs. What are possible options? sgc stimulators 2,3,4 Soluble guanylate cyclase stimulators Stimulators 3,4 sgc stimulators: work by making up a shortage of nitric oxide, which is one of the messengers that help blood vessels to relax prostacyclin analogs: mimic the body s own prostacyclin, another substance that PAH patients may lack, that also cause blood vessels to widen ERAs 2,3 Endothelin receptor antagonists Oral tablet Oral tablet PCAs 2,3 Prostacyclin analogs Continuous venous or subcutaneous infusion or inhaled Inhibitors 3 endothelin receptor antagonists: reverse the effects of endothelin, a chemical made in blood vessel walls that causes them to narrow Stimulators Inhibitors PDE5i 3 Phosphodiesterase type 5 inhibitors Oral tablet Combinable PDE-5 inhibitors: reduce the break down of cgmp, another substance involved in relaxing blood vessel walls Your treating physician will find out, which therapy will be most suitable for you. Not all therapies can be prescribed together; your PH specialist will advise you on the therapies that can be taken at the same time. 7 8

6 What is the best for you? How do you feel? Your PH specialist will work with you to find the best (s) to improve your symptoms. Paul s PH specialist I discussed with Paul how taking two different PAH s could help to improve his symptoms At your next visit, make sure you discuss with your PH team if there have been any changes in your symptoms, or if you experience any unexpected side effects while taking your PAH medication. 1 PAH 2 or 3 PAH s taken together Paul s PH specialist Paul experienced some side effects on his second, so I prescribed a different for him 9 Celine s PH specialist After discussion with Celine and the rest of the PH team, I decided to add a third to the two different oral s she is already taking If you also have any other medical conditions, your PH specialist will take these into account when suggesting a suitable for you. Have a think about how you ve been since your last clinic visit. It s very important your healthcare team have an accurate picture of what you personally go through day-to-day. That s because one of the main aims of PH is to make everyday living a little easier. 10

7 Treatment can be adjusted to suit you better Alice Your PH specialist will assess whether it is best for you to: I feel like I can finally breath properly again Paul Last night I read a story for my granddaughter without having to pause for breath Celine I have really noticed a difference in my daily life Stay on the same dose of your current Adjust the dose of your current Transition to a different PAH Add another PAH 11 12

8 References: 1. Galiè N et al. Guidelines for the diagnosis and of pulmonary hypertension. Eur Heart J 2009; 30: Ghofrani et al. Riociguat for the of pulmonary arterial hypertension. N Engl J Med 2013; 369: Duarte JD et al. Pharmacologic s for pulmonary hypertension: exploring pharmacogenomics. Future Cardiol 2013; 9: Galiè N et al. Updated algorithm of pulmonary arterial hypertension. JACC vol. 62; No 25, Suppl D, Bayer Pharma AG D Berlin, Germany Copyright Bayer Healthcare AG G.GM.RIO