Sotatercept treatment for 6 months improved hemodynamics and 6MWD in 75% of patients, while 17.5% showed incongruent responses with decreased mPAP but increased PVR due to reduced cardiac output.
Observational (n=40)
No
Does sotatercept improve hemodynamics and functional capacity in patients with pulmonary hypertension?
While most patients treated with sotatercept showed hemodynamic and functional improvement, a subgroup demonstrated incongruent hemodynamic findings characterized by decreased mPAP but increased PVR due to reduced CO.
Abstract Methods A retrospective analysis was conducted using a database from a Comprehensive Pulmonary Hypertension Center of patients treated with sotatercept. Hemodynamics, functional class (FC), six-minute walk distance (6MWD), Borg score, and REVEAL Risk Score (RRS) were compared before and after six months of treatment. In addition, modified oxygen delivery (O2D) and thermodilution cardiac output (CO) were assessed before and after treatment. Results Data from 40 patients (88% female; mean age 51 years) were analyzed. Overall, 70% of patients received systemic prostanoid therapy in combination with oral agents. Mean baseline measures included 6MWD 405.8 m, NT-proBNP 589.3 pg/mL, Borg score 2.5, REVEAL score 6.3, and O2D 9,032 mL/min. Three hemodynamic response groups were identified: responders (mPAP and PVR improvement; n = 30), non-responders (mPAP and PVR unchanged or worsened; n = 3), and incongruent responders (mPAP improvement with PVR worsening due to decrease in CO in 6/7 patients, n = 7). No significant differences in baseline demographics were observed among the responders and non-responders. The incongruent responder group had numerically lower mPAP and PVR as well as higher CO and 6MWD (Table 1). Among responders, the following parameters improved: 6MWD by 29.9 m (P 0.05), Borg score by 0.6 (P 0.05), RRS by 1.5 (P 0.05); NT-proBNP and O2D numerically improved (decrease of 115 pg/mL and improvement by 324.7 mL/min, respectively). In the non-responder group, all the parameters were unchanged (FC and Borg) or numerically worsened (6MWD by 4.5 m, NT-proBNP by 293 pg/mL, RRS by 1.0, and O2D by 1,193 mL/min). In the incongruent group, 6MWD worsened by 10.5 m, FC by 0.15, RRS by 0.4, and O2D by 1,862 mL/min while NT-proBNP and Borg score numerically improved (by 150 pg/mL and 0.6, respectively). Conclusion While most patients showed improvement in hemodynamic data, 6MWD, NT-proBNP, and RRS, a minority did not. In addition, a subgroup of patients demonstrated incongruent hemodynamic findings, characterized by a decrease in mPAP but an increase in PVR mostly due to a reduction in CO. Long term outcomes of patients with no hemodynamic improvement in and incongruent hemodynamic response are not known and require future investigation. This abstract is funded by: None
Shlobin et al. (Fri,) conducted a observational in Pulmonary Hypertension (n=40). Sotatercept vs. Baseline (pre-treatment) was evaluated on Hemodynamics, functional class, six-minute walk distance (6MWD), Borg score, and REVEAL Risk Score. Sotatercept treatment for 6 months improved hemodynamics and 6MWD in 75% of patients, while 17.5% showed incongruent responses with decreased mPAP but increased PVR due to reduced cardiac output.