Upfront triple combination therapy with selexipag: insights from a real world cohort in Chinese patients with pulmonary arterial hypertension - Report - MDSpire
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Upfront triple combination therapy with selexipag: insights from a real world cohort in Chinese patients with pulmonary arterial hypertension
Clinical Report: Real-World Evidence on Initial Triple Therapy Including Selexipag
Overview
This study evaluates the safety and efficacy of initial triple therapy including selexipag in Chinese patients with pulmonary arterial hypertension (PAH). Significant improvements in functional capacity, right heart structure, and risk stratification were observed over a median follow-up of 29 weeks.
Background
Pulmonary arterial hypertension (PAH) is a progressive disease that can lead to right heart failure and death. Current treatment guidelines recommend initial dual therapy for most patients, but many remain at medium to high risk. The addition of selexipag as a prostacyclin-pathway agent may enhance treatment outcomes, particularly in high-risk patients.
Data Highlights
Parameter
Baseline
Post-Treatment
P-Value
WHO FC II
26.7%
65.8%
<0.001
6MWD (m)
414 ± 108
480 (420, 506)
<0.001
NT-proBNP (pg/mL)
928 (307, 1,923)
455 (134, 1,678)
<0.001
3 Low-Risk Criteria
12.3%
50.7%
Significant Improvement
Key Findings
Triple-targeted therapy including selexipag is safe and effective in Chinese PAH patients.
65.8% of patients achieved WHO FC II after treatment compared to 26.7% at baseline (p < 0.001).
6-minute walk distance (6MWD) increased significantly from 414 m to 480 m (p < 0.001).
NT-proBNP levels decreased significantly from 928 pg/mL to 455 pg/mL (p < 0.001).
Improvement in right heart structure was observed, including right atrial area and right ventricle diameter.
The hazard ratio for disease progression was 0.177 for initial triple therapy compared to sequential therapy (p = 0.036).
Clinical Implications
The findings support the use of selexipag in initial triple therapy for PAH, particularly for improving functional capacity and right heart function. Clinicians should consider this approach for patients who remain at risk despite dual therapy.
Conclusion
Initial triple therapy including selexipag offers significant benefits for Chinese patients with PAH, enhancing both clinical outcomes and risk stratification. This strategy may improve long-term prognosis in this population.
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