Selexipag reduced NT-proBNP by 150.19 pg/mL, hospitalizations for worsening PH by 37%, and serious adverse events by 53%, without improving PVR, 6MWD, or mortality.
Does selexipag improve pulmonary vascular resistance and clinical outcomes in adults with pulmonary hypertension?
In adults with pulmonary hypertension, selexipag reduces hospitalizations, serious adverse events, and NT-proBNP levels, but shows no significant benefit on pulmonary vascular resistance or 6-minute walk distance.
Absolute Event Rate: 0% vs 0%
Selexipag, a selective prostacyclin receptor agonist, has been evaluated in randomized controlled trials (RCTs) for the treatment of pulmonary hypertension (PH), but results remain inconsistent. We performed an updated meta-analysis to assess its efficacy and safety. PubMed, Embase, and Cochrane databases were searched systematically from September 2025. Eligible studies were RCTs comparing selexipag with placebo in adults with PH. The primary outcome was the change in pulmonary vascular resistance (PVR). Secondary outcomes included 6-minute walk distance (6MWD), all-cause mortality, hospitalization for worsening PH, N-terminal pro-brain natriuretic peptide (NT-proBNP), serious adverse events (SAEs), and treatment-related adverse events (AEs). A random-effects meta-analysis was conducted using RevMan. Six RCTs enrolling 1686 patients were included. Selexipag therapy was associated with a statistically significant reduction in NT-proBNP (WMD = –150.19 pg/mL; 95% confidence interval CI –185.88 to −114.51), hospitalization for worsening PH (odds ratio OR = 0.63; 95% CI, 0.48–0.84), and SAEs (OR = 0.47; 95% CI, 0.38–0.59). Selexipag did not significantly reduce PVR (WMD = – 68.0 dyn·s·cm −5 ; 95% CI, –145.9 to 9.9) or improve 6MWD (WMD = –1.05 m; 95% CI, – 4.6 to 2.5), or mortality (OR = 0.80; 95% CI, 0.44–1.45) as compared with placebo. Selexipag reduces hospitalizations, SAEs, and NT-proBNP levels but shows no clear benefit on PVR or 6MWD. Future trials are needed to confirm these findings.
Alowami et al. (Wed,) reported a other. Selexipag reduced NT-proBNP by 150.19 pg/mL, hospitalizations for worsening PH by 37%, and serious adverse events by 53%, without improving PVR, 6MWD, or mortality.