Impact of different sequential triple oral combination therapies based selexipag on outcomes in pulmonary arterial hypertension

IF 2.4 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2024-02-25 DOI:10.1002/clc.24245

Xiaoyi Hu MD, Ping Yuan MD, Jun Chen MD, Shang Wang MD, Hui Zhao MD, Yaqin Wei MS, Jiaqi Fu MS, Fadong Chen MD, Hongyun Ruan MD, Wei Zhang MD, Yanli Zhou MD, Qiqi Wang MD, Xiaoling Xu MD, Kefu Feng MD, Jianzhou Guo MD, Sugang Gong MD, Ruifeng Zhang MD, Qinhua Zhao MD, Lan Wang MD

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引用次数: 0

Abstract

Background

While the GRIPHON study and others have confirmed the efficacy and safety of selexipag with single, dual, and initial triple combination therapy for patients with pulmonary arterial hypertension (PAH), multicenters studies concerning diverse triple oral combination therapies based on selexipag are limited.

Hypothesis

This study was conducted to evaluate the effects of various sequential triple oral combination therapies on PAH outcomes.

Methods

A retrospective study was carried out involving 192 patients from 10 centers, who were receiving sequential triple oral combination therapy consisting of an endothelin receptor antagonist (ERA), a phosphodiesterase 5 inhibitor (PDE5i)/riociguat and selexipag. Clinical parameters, event-free survival, and all-cause survival were assessed and analyzed at baseline and posttreatment.

Results

Among the 192 patients, 37 were treated with ERA + riociguat + selexipag, and 155 patients received ERA + PDE5i + selexipag. Both sequential triple oral combination therapies improved the World Health Organization functional class and raised the count of low-risk parameters. As a result of the larger patients' population in the ERA + PDE5i + selexipag group, these individuals exhibited significant increases in 6-minute walking distance (6MWD), pulmonary arterial systolic pressure, pulmonary arterial pressure, right ventricle, and eccentricity index, and significant decreases in N-terminal probrain natriuretic peptide after 6 months of treatment. Nevertheless, both sequential triple oral combination therapy groups demonstrated similar shifts in these clinical parameters between baseline and 6 months. Baseline 6MWD and mean pulmonary arterial pressure were independent predictors of survival in patients undergoing ERA + PDE5i + selexipag therapy. Importantly, no significant differences were found in 6-month event-free survival and all-cause survival between two groups.

Conclusions

Different oral sequential triple combination therapies based on selexipag could comparably improve outcomes in patients with PAH.

Abstract Image

查看原文本刊更多论文

基于 selexipag 的不同序贯三联口服联合疗法对肺动脉高压疗效的影响。

背景：虽然GRIPHON研究和其他研究已经证实了selexipag与单药、双药和初始三药联合疗法对肺动脉高压（PAH）患者的疗效和安全性，但有关基于selexipag的多种三药口服联合疗法的多中心研究还很有限：本研究旨在评估各种序贯三联口服联合疗法对 PAH 预后的影响：这项回顾性研究涉及来自 10 个中心的 192 名患者，他们接受了由内皮素受体拮抗剂 (ERA)、磷酸二酯酶 5 抑制剂 (PDE5i)/riociguat 和 selexipag 组成的序贯三联口服联合疗法。对基线和治疗后的临床参数、无事件生存率和全因生存率进行了评估和分析：在192名患者中，37人接受了ERA + riociguat + selexipag治疗，155人接受了ERA + PDE5i + selexipag治疗。这两种序贯三联口服联合疗法都改善了世界卫生组织的功能分级，并提高了低风险参数的计数。由于ERA + PDE5i + selexipag组的患者人数较多，因此在治疗6个月后，这些患者的6分钟步行距离（6MWD）、肺动脉收缩压、肺动脉压、右心室和偏心指数均显著增加，N末端 probrain钠尿肽显著下降。尽管如此，两组序贯三联口服联合疗法组在基线和 6 个月之间的临床参数变化相似。基线 6MWD 和平均肺动脉压是ERA + PDE5i + selexipag 治疗患者存活率的独立预测指标。重要的是，两组患者的 6 个月无事件生存率和全因生存率没有明显差异：基于selexipag的不同口服序贯三联疗法可显著改善PAH患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.