Key result
Transitioning from selexipag to oral treprostinil lowers REVEAL 2.0 risk scores in PAH case series.
Why the study?
There are no prospective studies or guidelines describing transition strategies between selexipag and oral treprostinil in PAH patients.
Case Report (n=2)
May support selexipag-to-oral treprostinil transitions in select PAH patients; hypothesis-generating and requires confirmation in larger studies.
There are no prospective studies or guidelines describing transition between selexipag and oral treprostinil. We present two different transition strategies from selexipag to oral treprostinil, one started inpatient and then completed at home, and one completely under outpatient settings. Neither patient experienced worsening prostacyclin-type adverse effects; both were rigorous in their attention to a 7-8 hour administration schedule for oral treprostinil, and both experienced objective clinical benefit at follow-up. Prospective studies are needed to help guide clinical decisions when patients remain intermediate risk after a trial of either drug.
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Arevalo et al. (2022) conducted a case report in Pulmonary arterial hypertension (n=2). Oral treprostinil vs. Baseline (selexipag) was evaluated on Clinical improvement and REVEAL 2.0 risk score. Transitioning from selexipag to oral treprostinil using either an inpatient or outpatient strategy yielded objective clinical benefit and reduced REVEAL 2.0 risk scores in two patients with pulmonary arterial hypertension.
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