Researchers provided a comprehensive overview of the advantages and drawbacks of prostacyclin and its analogs for the treatment of pulmonary arterial hypertension (PAH) in pediatric patients, as published in European Review for Medical and Pharmacological Sciences.

“Epoprostenol can be effective against severe pulmonary hypertension,” the authors said. Iloprost, on the other hand, can treat severe persistent PAH in newborns while inhaled iloprost can be used in pulmonary vasoreactivity testing.

Treprostinil shows the highest antiproliferative activity and beraprost may be effective in premature infants. However, the effect of beraprost is based on a single case study and needs to be validated with further research.

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The incidence of PAH is low among children, but the life expectancy of affected children is usually less than 10 months. This means that the condition has a great burden on families and society.

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The treatment options for the disease are limited and usually ineffective. Here, a team of researchers from the University of Electronic Science and Technology of China in Chengdu performed a review of the literature for studies in pediatric patients with PAH and their treatments with prostacyclins and analogs.

The team identified 238 articles published between December 1983 and May 2021. They found that 4 prostacyclin compounds are mainly used to treat PAH and that different prostacyclin analogs have different advantages and disadvantages.

“Our deepening understanding of [pulmonary hypertension], the remarkable development of biological and genetic approaches, new drug research, and better clinical monitoring and record-keeping should help improve the treatment and management of children with [pulmonary hypertension],” the authors concluded.

Due to the lower incidence of PAH among children, there have not been many multicenter studies that analyzed the effects of prostacyclin or its analogs.


Wu Y, Liu HM, Gu L, Li QW, Zhu L. Prostacyclins and pulmonary arterial hypertension in children. Eur Rev Med Pharmacol Sci. 2022;26(1):37-45. doi:10.26355/eurrev_202201_27745