Why the study?
The optimal timing of intravenous prostacyclin-analog therapy in pulmonary arterial hypertension remains debated, and controlled studies evaluating upfront triple therapy are lacking.
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Intravenous prostacyclin-analog therapy is recommended for PAH patients from functional class III onwards, though optimal timing and the use of upfront triple therapy require further controlled studies.
Various IV PCA have been evaluated in the treatment of patients with PAH. Today, combination therapy is the 'gold standard' for the majority of patients. Intravenous PCA is recommended from functional class III onwards. Timing of its initiation is still a point of discussion. An escalation of therapy to IV or SC PCA is always necessary if a low-risk status cannot be achieved with other targeted therapies. Preliminary data suggest that selected patients could benefit from an 'upfront triple' therapy. Controlled studies on which such recommendation could be based are lacking.
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Ewert et al. (2021) studied this question.
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