Initial dual oral combination therapy in pulmonary arterial hypertension
Why the study?
Does initial dual oral combination therapy improve functional outcomes, hemodynamics, and survival in patients with newly diagnosed pulmonary arterial hypertension?
Population
97 patients with newly diagnosed pulmonary arterial hypertension, 86% in New York Heart Association…
Comparison
Initial dual oral combination treatment with… vs Expected survival rates calculated from the…
Design
Cohort
Follow-up
median 30 months
Authors
Discussion
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Member takes
Implication
May support initial dual oral therapy in new PAH; hypothesis-generating for survival benefit versus historical controls.
Key Points
- This study aims to evaluate the effectiveness of initial dual oral combination therapy in patients with pulmonary arterial hypertension.
- Retrospective analysis of 97 patients with newly diagnosed PAH.
- Patients received dual oral combination therapy with various combinations of bosentan, sildenafil, ambrisentan, and tadalafil.
- Follow-up duration averaged 30 months to assess clinical outcomes.
- 82% of patients remained alive after 30 months, with 71% receiving only dual therapy.
- Overall survival rates were 97% at 1 year, 94% at 2 years, and 83% at 3 years.
- Dual therapy showed significant improvements in functional class, exercise capacity, dyspnoea, and haemodynamic indices after 4 months.
Structured PICO
Does initial dual oral combination therapy improve functional outcomes, hemodynamics, and survival in patients with newly diagnosed pulmonary arterial hypertension?
P
Population
97 patients with newly diagnosed pulmonary arterial hypertension (PAH), 86% in New York Heart Association (NYHA) functional class III-IV
I
Intervention
Initial dual oral combination treatment with bosentan plus sildenafil (n=61), bosentan plus tadalafil (n=17), ambrisentan plus tadalafil (n=11) or ambrisentan plus sildenafil (n=8)
C
Comparator
Expected survival rates calculated from the French equation (historical reference)
O
Outcome
Improvements in functional class, exercise capacity, dyspnoea and haemodynamic indices after 4 months of therapy, and overall survival at 1, 2 and 3 yearshard clinical
Initial dual oral combination therapy in newly diagnosed PAH is associated with significant clinical and hemodynamic improvements and better-than-expected survival.
Limitations
- Retrospective analysis
Cite This Study
Sitbon et al. (2016) studied this question.