Table 1.

Risks and benefits of the various treprostinil formulations

Treprostinil routea	Risks [9–11]	Benefits		Other considerations
		Placebo-corrected Hodges-Lehmann median change in 6MWD after 12 weeks [5, 7, 39]	Survival [6, 24, 38]
Parenteral treprostinil (Remodulin®)	Indwelling central catheter, bloodstream infection, sepsis (IV) Injection-site pain, occasionally requiring narcotics (SC) Headache Diarrhea, nausea Rash Jaw pain Vasodilation Edema Hypotension	+16 m (as monotherapy)	1 year: 87 % 2 years: 78 % 3 years: 71 % 4 years: 68 %	Device required Continuous infusion Ability to titrate dose
Inhaled (Tyvaso®)	Cough, throat irritation, pharyngolaryngeal pain Headache, flushing Nausea, diarrhea Dizziness Jaw pain	+20 m (with single oral background therapy)	1 year: 97 % 2 years: 91 % 3 years: 82 %	Device required; part replacement and cleaning qid dosing Titrate to a maximum dose (72 µg)
Oral (Orenitram®)	Headache Diarrhea, nausea Flushing Pain in jaw Pain in extremity Hypokalemia Abdominal discomfort	+23 m (as monotherapy)	1 year: 92 % 2 years: 87 %b 3 years: 82 %b	No device required bid or tid dosing Take with food Ability to titrate dose

6MWD 6-min walk distance, bid twice daily, IV intravenous, qid four times daily, SC subcutaneous, tid three times daily

^aSee Table 2 for additional details on the pivotal trials for each formulation

^bStudy ongoing. Patients had an opportunity to reach 2 and 3 years of Orenitram^® therapy