What question did this study set out to answer?

Investigate if early triple therapy with selexipag maintains treatment efficacy against worsening conditions in pulmonary arterial hypertension.

January 14, 2026Open Access

Could We Maintain the Initial Efficacy of Triple Sequential Combination Therapies with Selexipag Against Progressive Deterioration Risk in Patients with Pulmonary Arterial Hypertension: Insights from a Single-Center Study?

Key Result

Earlier escalation to triple therapy with selexipag may improve survival outcomes in patients with pulmonary arterial hypertension according to baseline risk.

Key Points

Investigate if early triple therapy with selexipag maintains treatment efficacy against worsening conditions in pulmonary arterial hypertension.
Conducted a single-center study
Examined associations between baseline risk and survival
Evaluated the impact of selexipag dosage over one year
Baseline risk linked to increased survival rates
Decline in treatment effect noted after one year
Early escalation to triple therapy suggested for better outcomes

Structured PICO

Does sequential triple combination therapy with selexipag improve long-term clinical parameters and survival in patients with pulmonary arterial hypertension?

Population

127 patients with pulmonary arterial hypertension (PAH) from a single-center registry, mean age 43.2 years, 84.3% female. Key subtypes include idiopathic PAH (45.7%) and PAH associated with congenital heart disease (45.7%).

Intervention

Selexipag (oral prostacyclin receptor agonist) added to background PAH therapies as part of sequential triple combination therapy. Doses ranged from 200 μg to 1600 μg twice daily.

Outcome

Longitudinal changes in clinical, echocardiographic, and hemodynamic variables, multiparametric risk scores (MRSs), and all-cause mortality

Sequential triple therapy with selexipag in PAH provides early clinical and hemodynamic improvements that attenuate after one year, with long-term survival driven by baseline risk rather than the achieved selexipag dose.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Earlier escalation to triple therapy with selexipag may improve outcomes. Baseline risk-but not achieved selexipag dose-was associated with survival. A possible decline in treatment effect after 1 year warrants further investigation.

Bookmark

View Full Paper