Key result
Initial oral combination therapy in PAH is linked to ~35% lower PVR despite poor low-risk achievement.
Why the study?
Initial oral combination therapy is recommended in PAH, but its effects on risk reduction and pulmonary vascular resistance are not known.
Does initial combination of oral endothelin receptor antagonist and phosphodiesterase-5 inhibitor drugs improve pulmonary vascular resistance and risk status in treatment-naive patients with pulmonary arterial hypertension?
Population
181 treatment-naive patients with PAH
Comparison
Initial combination of ERA plus PDE-5 inhibitor drugs
Design
Cohort study
Follow-up
6 months (interquartile range, 144–363 d)
Authors
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Should not yet change initial PAH therapy approaches; hypothesis-generating for escalation strategies to improve risk status.
Cohort (n=181)
Does initial combination of oral endothelin receptor antagonist and phosphodiesterase-5 inhibitor drugs improve pulmonary vascular resistance and risk status in treatment-naive patients with pulmonary arterial hypertension?
Despite initial combination therapy reducing pulmonary vascular resistance by an average of 35%, less than half of treatment-naive PAH patients achieved a low-risk status at 6 months.
Badagliacca et al. (2020) conducted a cohort in Pulmonary arterial hypertension (n=181). Initial oral combination of endothelin receptor antagonist and phosphodiesterase-5 inhibitor was evaluated on Reduction of pulmonary vascular resistance and achievement of low-risk status. Initial oral combination therapy in PAH decreased PVR by an average of 35%, but a low-risk status at 6 months was achieved in only 34.8% to 43.1% of patients.
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