Key result
CCB therapy fails in ~50% of initially responsive IPAH patients over long-term follow-up.
Why the study?
Little is known about whether patients with idiopathic PAH who respond to CCBs maintain a sustained response over longer periods of time.
Do idiopathic pulmonary arterial hypertension patients lose their clinical response to calcium channel blockers after long-term follow-up?
Cohort (n=26)
No
Do idiopathic pulmonary arterial hypertension patients lose their clinical response to calcium channel blockers after long-term follow-up?
Initial true responders to calcium channel blockers with idiopathic PAH require continuous multidimensional reassessment, as half may lose clinical response and require targeted therapy over long-term follow-up.
Idiopathic PAH CCB responders warrant serial reassessment; this cohort evidence leaves open durability predictors and optimal long-term strategies.
Idiopathic pulmonary arterial hypertension (PAH) patients with a positive response to acute vasodilator challenge and a clinical response to calcium channel blockers (CCBs) for at least one year are traditionally designated true responders. Nevertheless, little is known about a sustained response to CCBs over longer periods of time. We evaluated the loss of response to CCBs after long-term treatment in a cohort of idiopathic PAH patients previously classified as being true responders. Our data suggest that idiopathic PAH patients can lose clinical response to CCBs even after one year of clinical stability, reinforcing the need for constant multidimensional reevaluation to assess the need for targeted PAH therapies and to classify these patients correctly.
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Piloto et al. (2023) conducted a cohort in Idiopathic pulmonary arterial hypertension (n=26). Calcium channel blockers was evaluated on Loss of clinical response to calcium channel blockers after at least one year of treatment. Among idiopathic pulmonary arterial hypertension patients with a positive clinical response to calcium channel blockers for one year, 50% lost their response after a mean of 47 months and required targeted therapy.
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