What question did this study set out to answer?

To evaluate treatment patterns and outcomes of selexipag in pulmonary arterial hypertension patients based on their risk levels.

January 14, 2026Open Access

Real-World Experience with Selexipag in Patients with Pulmonary Arterial Hypertension: Treatment Patterns and Outcomes across Baseline Risk Strata (SPHERE and EXPOSURE Studies)

Key Result

Selexipag-treated patients in low and intermediate-low risk groups had lower hospitalization rates and better survival compared to higher risk groups.

Key Points

To evaluate treatment patterns and outcomes of selexipag in pulmonary arterial hypertension patients based on their risk levels.
Analyzed data from SPHERE and EXPOSURE studies
Categorized patients into baseline risk strata
Compared hospitalization rates and survival outcomes among different risk groups.
Over half of patients started selexipag nearly 3 years after diagnosis.
38% of patients were at intermediate-high or high risk of 1-year mortality at treatment initiation.
Lower hospitalization rates and better survival were seen in low and intermediate-low risk groups compared to higher risk groups.

Structured PICO

Population

894 adults with pulmonary arterial hypertension (PAH) newly initiating selexipag, median age 61, 73.7% female, median time since diagnosis 2.7 years. 67% on triple oral combination therapy, 61% WHO-FC III. Multinational (USA, Europe, Canada).

Intervention

Selexipag (oral selective prostacyclin I2 receptor agonist), median individualised dose 800 μg twice-daily, added to baseline PAH therapy.

Outcome

All-cause hospitalisation and all-cause mortality at 1 year across baseline risk stratahard clinical

Real-world data show that many PAH patients initiate selexipag late in their disease course when already at high risk, highlighting the need for earlier treatment escalation to improve survival and reduce hospitalizations.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Despite current guidelines, over half of patients started selexipag almost 3 years after diagnosis, and 38% were already intermediate-high or high risk of 1-year mortality. Lower hospitalisation rates and better survival were observed for selexipag-treated patients in the low and intermediate-low risk groups versus higher risk groups.

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