马西替坦治疗结缔组织病相关肺动脉高压(CTD-PAH):来自 OPUS/OrPHeUS 联合数据集的真实世界证据。

IF 3 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiology and Therapy Pub Date : 2024-06-01 Epub Date: 2024-03-07 DOI:10.1007/s40119-024-00361-w
Richard Channick, Kelly M Chin, Vallerie V McLaughlin, Matthew R Lammi, Roham T Zamanian, Stefano Turricchia, Rose Ong, Lada Mitchell, Nick H Kim
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引用次数: 0

摘要

导言:有关结缔组织病相关肺动脉高压(CTD-PAH)患者的实际临床实践和疗效的数据很少。OPUS/OrPHeUS 研究招募了新开始使用马西替坦的患者,包括 CTD-PAH 患者。本分析利用 OPUS/OrPHeUS 合并数据集描述了美国新开始使用马西替坦的 CTD-PAH 患者的特征、治疗模式、结果和安全性概况:OPUS 是一项前瞻性的美国多中心长期观察性药物登记项目(2014 年 4 月至 2020 年 6 月)。OrPHeUS是一项回顾性美国多中心病历审查(2013年10月至2017年3月)。研究人员对 CTD-PAH 及其亚组系统性硬化症(SSc-PAH)、系统性红斑狼疮(SLE-PAH)和混合 CTD(MCTD-PAH)患者与特发性/遗传性 PAH(I/HPAH)患者在马西替坦治疗期间的特征、治疗模式、安全性和预后进行了描述性比较:OPUS/OrPHeUS合并人群包括2498例I/HPAH患者和1192例CTD-PAH患者(708例SSc-PAH;159例SLE-PAH;124例MCTD-PAH和201例其他CTD-PAH病因)。在开始使用马西替坦时,I/HPAH 和 CTD-PAH 患者的比例分别为 61.2% 和 69.3%:61.2%和69.3%的患者处于世界卫生组织功能分级(WHO FC)III/IV级;6分钟步行距离中位数分别为289米和279米;58.1%和65.2%的患者接受了马西替坦联合治疗。在随访期间,I/HPAH和CTD-PAH患者的中位马西替坦暴露时间分别为14.0个月和15.8个月;79.0%和83.0%的患者发生过不良事件;1年后无全因住院患者的Kaplan-Meier估计值(95%置信区间[CL])分别为60.3%(58.1,62.0%)和65.2%(58.1,62.2%)。3%(58.1,62.4)和59.3%(56.1,62.3);1年生存率的Kaplan-Meier估计值(95%置信区间)分别为90.5%(89.1,91.7)和90.6%(88.6,92.3):马西替坦可用于CTD-PAH患者及其亚组的临床实践,包括联合治疗。马西替坦在CTD-PAH患者中的安全性和耐受性与I/HPAH患者相当:试验注册:OPsumit®用户登记处(OPUS):试验注册:OPsumit®使用者注册中心(OPUS):NCT02126943;Opsumit®历史使用者队列(OrPHeUS):NCT03197688;Opsumit®临床试验注册中心(OPUS):NCT03197688:NCT03197688;www.Clinicaltrials: gov 本文有图表摘要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Macitentan in Pulmonary Arterial Hypertension Associated with Connective Tissue Disease (CTD-PAH): Real-World Evidence from the Combined OPUS/OrPHeUS Dataset.

Introduction: Data on real-world clinical practice and outcomes of patients with pulmonary arterial hypertension associated with connective tissue disease (CTD-PAH) are scarce. The OPUS/OrPHeUS studies enrolled patients newly initiating macitentan, including those with CTD-PAH. This analysis describes patient characteristics, treatment patterns, outcomes, and safety profiles of patients with CTD-PAH newly initiating macitentan in the US using the OPUS/OrPHeUS combined dataset.

Methods: OPUS was a prospective, US, multicenter, long-term, observational drug registry (April 2014-June 2020). OrPHeUS was a retrospective, US, multicenter medical chart review (October 2013-March 2017). The characteristics, treatment patterns, safety, and outcomes during macitentan treatment of patients with CTD-PAH and its subgroups systemic sclerosis (SSc-PAH), systemic lupus erythematosus (SLE-PAH), and mixed CTD (MCTD-PAH) were descriptively compared to patients with idiopathic/heritable PAH (I/HPAH).

Results: The combined OPUS/OrPHeUS population included 2498 patients with I/HPAH and 1192 patients with CTD-PAH (708 SSc-PAH; 159 SLE-PAH; 124 MCTD-PAH, and 201 other CTD-PAH etiologies). At macitentan initiation for patients with I/HPAH and CTD-PAH, respectively: 61.2 and 69.3% were in World Health Organization functional class (WHO FC) III/IV; median 6-min walk distance was 289 and 279 m; and 58.1 and 65.2% received macitentan as combination therapy. During follow-up, for patients with I/HPAH and CTD-PAH, respectively: median duration of macitentan exposure observed was 14.0 and 15.8 months; 79.0 and 83.0% experienced an adverse event; Kaplan-Meier estimates (95% confidence limits [CL]) of patients free from all-cause hospitalization at 1 year were 60.3% (58.1, 62.4) and 59.3% (56.1, 62.3); and Kaplan-Meier estimates (95% CL) of survival at 1 year were 90.5% (89.1, 91.7) and 90.6% (88.6, 92.3).

Conclusions: Macitentan was used in clinical practice in patients with CTD-PAH and its subgroups, including as combination therapy. The safety and tolerability profile of macitentan in patients with CTD-PAH was comparable to that of patients with I/HPAH.

Trial registration: OPsumit® Users Registry (OPUS): NCT02126943; Opsumit® Historical Users cohort (OrPHeUS): NCT03197688; www.

Clinicaltrials: gov Graphical abstract available for this article.

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来源期刊
Cardiology and Therapy
Cardiology and Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.30
自引率
0.00%
发文量
38
审稿时长
6 weeks
期刊介绍: Aims and Scope Cardiology and Therapy is an international, open access, peer reviewed (single-blind), rapid-publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of cardiovascular therapies and interventions, including devices. Studies relating to diagnosis and diagnostics, pharmacoeconomics, public health, quality of life, as well as patient care, management and education are also encouraged. Areas of focus include, but are not limited to, ischaemic heart disease and acute cardiac care, myocardial, valvular, pericardial and congenital heart disease, vascular and pulmonary disease (including hypertension), arrhythmias, heart failure, non-invasive diagnostic techniques, and invasive and interventional cardiology as well as cardiovascular surgery. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols and short communications such as commentaries and editorials. Cardiolology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. Rapid Publication The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of cardiovascular therapies. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning authors will always have an editorial contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. Digital Features and Plain Language Summaries Cardiology and Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’. For examples of digital features please visit our showcase page https://springerhealthcare.com/expertise/publishing-digital-features/ Publication Fees Upon acceptance of your article for publication, authors will be required to pay the mandatory Rapid Service Fee of £3650/€4500/$5100. The journal will consider fee discounts for developing countries and this is decided on a case by case basis. Open Access All articles published by Cardiology and Therapy are published open access. Peer Review Process Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria. At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials and Letters which are generally reviewed by one member of the Editorial Board. Where reviewer recommendations are conflicted, the editorial board will be contacted for further advice and a presiding decision. 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