Sotatercept treatment in PAH patients with comorbidities significantly improved 6-minute walk distance (327 to 377m, p=0.011) and mean pulmonary arterial pressure (47 to 36 mmHg, p<0.001).
Observational (n=23)
Does Sotatercept improve hemodynamics and functional capacity in patients with pulmonary arterial hypertension and multiple comorbidities?
p-value: p=<0.001
Abstract Background Pulmonary arterial hypertension (PAH) is a progressive disease characterized by functional deterioration and high mortality. Previous studies have demonstrated that the presence of comorbidities affects tolerability of PH therapies and have a subsequent blunted response. This study assessed the efficacy and tolerability of Sotatercept in patients with PAH and multiple comorbidities. Methods Of 130 patients initiated on Sotatercept, 23 patients had two available sets of hemodynamic data; one prior to Sotatercept initation and at least one follow-up right heart catheterization (RHC). Real word data from these 23 PAH patients were reviewed. We assessed hemodynamics parameters such as echo changes, PVR, and mPAP. Functional, hemodynamic and laboratory parameters were assessed at baseline and at least 6 months after therapy. Results Mean age was 52 ± 14 years, 83% female, 65% IPAH, 22% CTD, 4% Familial PAH and 9% were Drug-induced. Comorbidities included obesity (52%) with a median BMI of 31.1± 3.0 kg/m2, OSA (52%), Hypertension (43%), CKD (30%), and diabetes (22%). 13% (n = 3) of patients had 0 comorbidities, 30% (n = 7) of patients had 1 comorbidity, 30% (n = 7) of patients had 2 comorbidities, 4 % (n = 1) of patients had 3 comorbidities, 13% (n = 3) of patients had 4 comorbidities, and 9% (n = 2) of patients had 5 comorbidities. 83% of patients were on triple therapy prior to Sotatercept and remained on stable background therapy after initiation. Despite the presence of comorbidities, Sotatercept treatment led to significant improvements in 6-minute walk distance (327 to 377m, p = 0.011), mean pulmonary arterial pressure (47 to 36 mmHg, p 0.001), PVR (7.7 to 5.1 WU, p = 0.011), and hemoglobin increase from 12.20 ± 1.88 to 13.67 ± 2.36 g/dL (p 0.001) after median of 14 doses of Sotatercept over a median period of 14 months. NT-proBNP levels were evaluated from baseline to the most recent follow-up, showing reduction from 541.00 (97.00,2323.00) to 194.00 (57, 427) pg/mL (p = 0.006). Functional class improved in 26% of patients with a median REVEAL Lite 2 score of 8 at baseline to 6 at the most recent assessment, p = 0.001. There was no increase in bleeding events or PH-related hospitalizations after treatment. There was no discontinuation of Sotatercept due to comorbidity related tolerability issues. Conclusions Our findings indicate that Sotatercept was well tolerated and associated with significant hemodynamic and functional improvement in patients with PAH with associated comorbidities. These findings support the clinical benefit of Sotatercept across diverse, real-world PAH populations. This abstract is funded by: None
Maestre et al. (Fri,) conducted a observational in Pulmonary arterial hypertension (PAH) with comorbidities (n=23). Sotatercept was evaluated on Hemodynamic and functional parameters including 6-minute walk distance, mean pulmonary arterial pressure, and pulmonary vascular resistance (p=<0.001). Sotatercept treatment in PAH patients with comorbidities significantly improved 6-minute walk distance (327 to 377m, p=0.011) and mean pulmonary arterial pressure (47 to 36 mmHg, p<0.001).