Effectiveness, Safety, and Economic Comparison of Inhaled Epoprostenol Brands, Flolan and Veletri, in Acute Respiratory Distress Syndrome.

No previous studies exist examining 2 inhaled epoprostenol formulations in an acute respiratory distress syndrome (ARDS) patient population. The study aim was to evaluate a formulary conversion from inhaled Flolan to Veletri to determine the impact on effectiveness, safety, and cost in patients with ARDS. This was a single-center, retrospective, matched cohort observational study at a tertiary care academic medical center. Patients included were mechanically ventilated, adult patients with ARDS receiving inhaled Flolan or Veletri for ≥1 hour in the intensive care unit. A total of 132 patients were included in the matched cohort. There was no difference detected in change in partial pressure of arterial O/fraction of inspired O (PaO/FiO) ratio after 1 hour of therapy between the inhaled Flolan and Veletri groups (27.2 ± 46.2 vs 30 ± 68 mm Hg, = 0.78). Significant differences in secondary outcomes included incidence of hypotension (83% vs 95.5%, = 0.04) and thrombocytopenia (9.1% vs 29.5%, < 0.01) in the inhaled Flolan and Veletri groups, respectively, with no difference in cost per duration of therapy ( = 0.29). There was no difference in the change in PaO/FiO ratio after 1 hour of therapy between inhaled Flolan and Veletri in an ARDS patient population. The formulary conversion from inhaled Flolan to Veletri was likely justified.