Evaluating the efficacy and safety of oral triple sequential combination therapy for treating patients with pulmonary arterial hypertension: A multicenter retrospective study
Abstract This study aimed to evaluate the effectiveness and safety of an oral sequential triple combination therapy with selexipag after dual combination therapy with endothelin receptor antagonist (ERA) and phosphodiesterase‐5 inhibitor (PDE5I)/riociguat in pulmonary arterial hypertension (PAH) pat...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-01-01
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| Series: | Pulmonary Circulation |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/pul2.12351 |
| _version_ | 1797236695867850752 |
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| author | Qin‐Hua Zhao Jun Chen Fa‐Dong Chen Hong‐Yun Ruan Wei Zhang Yan‐Li Zhou Qi‐Qi Wang Xiao‐Ling Xu Ke‐Fu Feng Jian‐Zhou Guo Su‐Gang Gong Rui‐Feng Zhang Lan Wang |
| author_facet | Qin‐Hua Zhao Jun Chen Fa‐Dong Chen Hong‐Yun Ruan Wei Zhang Yan‐Li Zhou Qi‐Qi Wang Xiao‐Ling Xu Ke‐Fu Feng Jian‐Zhou Guo Su‐Gang Gong Rui‐Feng Zhang Lan Wang |
| author_sort | Qin‐Hua Zhao |
| collection | DOAJ |
| description | Abstract This study aimed to evaluate the effectiveness and safety of an oral sequential triple combination therapy with selexipag after dual combination therapy with endothelin receptor antagonist (ERA) and phosphodiesterase‐5 inhibitor (PDE5I)/riociguat in pulmonary arterial hypertension (PAH) patients. A total of 192 PAH patients from 10 centers had received oral sequential selexipag therapy after being on dual‐combination therapy with ERA and PDE5i/riociguat for a minimum of 3 months. Clinical data were collected at baseline and after 6 months of treatment. The study analyzed the event‐free survival at 6 months and all‐cause death over 2 years. At baseline, the distribution of patients among the risk groups was as follows: 22 in the low‐risk group, 35 in the intermediate‐low‐risk group, 91 in the intermediate‐high‐risk group, and 44 in the high‐risk group. After 6 months of treatment, the oral sequential triple combination therapy resulted in reduced NT‐proBNP levels (media from 1604 to 678 pg/mL), a decline in the percentage of WHO‐FC III/IV (from 79.2% to 60.4%), an increased in the 6MWD (from 325 ± 147 to 378 ± 143 m) and a rise in the percentage of patients with three low‐risk criteria (from 5.7% to 13.5%). Among the low‐risk group, there was an improvement in the right heart remodeling, marked by a decrease in right atrium area and eccentricity index. The intermediate‐low‐risk group exhibited significant enhancements in WHO‐FC and tricuspid annular plane systolic excursion. For those in the intermediate‐high and high‐risk groups, there were marked improvements in activity tolerance, as reflected by WHO‐FC and 6MWD. The event‐free survival rate at 6 months stood at 88%. Over the long‐term follow‐up, the survival rates at 1 and 2 years were 86.5% and 86.0%, respectively. In conclusion, the oral sequential triple combination therapy enhanced both exercise capacity and cardiac remodeling across PAH patients of different risk stratifications. |
| first_indexed | 2024-04-24T17:07:57Z |
| format | Article |
| id | doaj.art-0cadbfafa3bc41afbb7e5520273a0063 |
| institution | Directory Open Access Journal |
| issn | 2045-8940 |
| language | English |
| last_indexed | 2024-04-24T17:07:57Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Circulation |
| spelling | doaj.art-0cadbfafa3bc41afbb7e5520273a00632024-03-28T19:28:30ZengWileyPulmonary Circulation2045-89402024-01-01141n/an/a10.1002/pul2.12351Evaluating the efficacy and safety of oral triple sequential combination therapy for treating patients with pulmonary arterial hypertension: A multicenter retrospective studyQin‐Hua Zhao0Jun Chen1Fa‐Dong Chen2Hong‐Yun Ruan3Wei Zhang4Yan‐Li Zhou5Qi‐Qi Wang6Xiao‐Ling Xu7Ke‐Fu Feng8Jian‐Zhou Guo9Su‐Gang Gong10Rui‐Feng Zhang11Lan Wang12Department of Pulmonary Circulation, Shanghai Pulmonary Hospital Tongji University School of Medicine Shanghai ChinaDepartment of Cardiology Xiamen Hospital of Traditional Chinese Medicine Fujian ChinaDepartment of Cardiology, Tongji Hospital Tongji University School of Medicine Shanghai ChinaDepartment of Cardiology Xuzhou Central Hospital Xuzhou ChinaDepartment of Rheumatology, Renji Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaDepartment of Cardiology First Affiliated Hospital of Nanjing Medical University Nanjing ChinaDepartment of Cardiology and Atrial Fibrillation Center, The First Affiliated Hospital College of Medicine Zhejiang University Hangzhou Zhejiang ChinaDepartment of Pulmonary and Critical Care Medicine, Sir Run Run Shaw Hospital Zhejiang University School of Medicine Hangzhou ChinaDivision of Life Sciences and Medicine, Department of Cardiology, The First Affiliated Hospital of USTC University of Science and Technology of China Hefei Anhui ChinaDepartment of Cardiovascular Surgery, Fuwai Hospital Chinese Academy of Medical Sciences Guangdong Province Shenzhen ChinaDepartment of Pulmonary Circulation, Shanghai Pulmonary Hospital Tongji University School of Medicine Shanghai ChinaDepartment of Respiratory Medicine Zhongda Hospital of Southeast University Nanjing ChinaDepartment of Pulmonary Circulation, Shanghai Pulmonary Hospital Tongji University School of Medicine Shanghai ChinaAbstract This study aimed to evaluate the effectiveness and safety of an oral sequential triple combination therapy with selexipag after dual combination therapy with endothelin receptor antagonist (ERA) and phosphodiesterase‐5 inhibitor (PDE5I)/riociguat in pulmonary arterial hypertension (PAH) patients. A total of 192 PAH patients from 10 centers had received oral sequential selexipag therapy after being on dual‐combination therapy with ERA and PDE5i/riociguat for a minimum of 3 months. Clinical data were collected at baseline and after 6 months of treatment. The study analyzed the event‐free survival at 6 months and all‐cause death over 2 years. At baseline, the distribution of patients among the risk groups was as follows: 22 in the low‐risk group, 35 in the intermediate‐low‐risk group, 91 in the intermediate‐high‐risk group, and 44 in the high‐risk group. After 6 months of treatment, the oral sequential triple combination therapy resulted in reduced NT‐proBNP levels (media from 1604 to 678 pg/mL), a decline in the percentage of WHO‐FC III/IV (from 79.2% to 60.4%), an increased in the 6MWD (from 325 ± 147 to 378 ± 143 m) and a rise in the percentage of patients with three low‐risk criteria (from 5.7% to 13.5%). Among the low‐risk group, there was an improvement in the right heart remodeling, marked by a decrease in right atrium area and eccentricity index. The intermediate‐low‐risk group exhibited significant enhancements in WHO‐FC and tricuspid annular plane systolic excursion. For those in the intermediate‐high and high‐risk groups, there were marked improvements in activity tolerance, as reflected by WHO‐FC and 6MWD. The event‐free survival rate at 6 months stood at 88%. Over the long‐term follow‐up, the survival rates at 1 and 2 years were 86.5% and 86.0%, respectively. In conclusion, the oral sequential triple combination therapy enhanced both exercise capacity and cardiac remodeling across PAH patients of different risk stratifications.https://doi.org/10.1002/pul2.12351eventoral sequential triple combination therapypulmonary arterial hypertensionrisk stratificationsurvival |
| spellingShingle | Qin‐Hua Zhao Jun Chen Fa‐Dong Chen Hong‐Yun Ruan Wei Zhang Yan‐Li Zhou Qi‐Qi Wang Xiao‐Ling Xu Ke‐Fu Feng Jian‐Zhou Guo Su‐Gang Gong Rui‐Feng Zhang Lan Wang Evaluating the efficacy and safety of oral triple sequential combination therapy for treating patients with pulmonary arterial hypertension: A multicenter retrospective study Pulmonary Circulation event oral sequential triple combination therapy pulmonary arterial hypertension risk stratification survival |
| title | Evaluating the efficacy and safety of oral triple sequential combination therapy for treating patients with pulmonary arterial hypertension: A multicenter retrospective study |
| title_full | Evaluating the efficacy and safety of oral triple sequential combination therapy for treating patients with pulmonary arterial hypertension: A multicenter retrospective study |
| title_fullStr | Evaluating the efficacy and safety of oral triple sequential combination therapy for treating patients with pulmonary arterial hypertension: A multicenter retrospective study |
| title_full_unstemmed | Evaluating the efficacy and safety of oral triple sequential combination therapy for treating patients with pulmonary arterial hypertension: A multicenter retrospective study |
| title_short | Evaluating the efficacy and safety of oral triple sequential combination therapy for treating patients with pulmonary arterial hypertension: A multicenter retrospective study |
| title_sort | evaluating the efficacy and safety of oral triple sequential combination therapy for treating patients with pulmonary arterial hypertension a multicenter retrospective study |
| topic | event oral sequential triple combination therapy pulmonary arterial hypertension risk stratification survival |
| url | https://doi.org/10.1002/pul2.12351 |
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