Abstract Introduction Group 3 pulmonary hypertension (PH), due to chronic lung disease, is associated with limited therapeutic options and poor outcomes. While Sotatercept has demonstrated significant benefit in Group 1 PH, its long-term clinical effect in Group 3 PH remains unknown. Treatment stability—defined as the absence of background therapy uptitration—may serve as a meaningful real-world marker of clinical benefit in this high-risk population. We aimed to evaluate treatment stability and duration of therapy among Group 3 PH patients initiated on sotatercept at a tertiary PH referral center. Methods We retrospectively analyzed 16 Group 3 PH patients initiated on Sotatercept between 2024-2025. Demographics, background PH therapy, duration of Sotatercept treatment, and need for therapy escalation were collected. Treatment stability was defined as no uptitration or addition of PH therapies during Sotatercept use. Time on therapy was calculated from sotatercept initiation to most recent clinical encounter, transplant, or death. Results Among the 16 Group 3 PH patients, 14 patients (87.5%) remained stable on Sotatercept without requiring uptitration of background PH therapy, while 2 patients (12.5%) required escalation during follow-up. The mean time on Sotatercept was 256 days (≈ 8.4 months), with a median of 240 days and a range of 92 to 450 days. Most patients (N = 12, 75%) remained on therapy beyond 6 months, and several (N = 3, 18.75%) exceeded 1 year of continuous treatment. At last follow-up, the majority of patients were alive and transplant-free, with no therapy discontinuations due to adverse effects or loss of efficacy. This high rate of treatment stability occurred in a population historically prone to clinical deterioration and progressive oxygen dependence. Conclusion In this real-world Group 3 PH cohort, Sotatercept was associated with a high rate of treatment stability over a median of 8 months, with nearly 9 in 10 patients not requiring additional PH therapy. These findings suggest that Sotatercept may have a disease-stabilizing effect in Group 3 PH—a population with historically few therapeutic options—and support the need for prospective studies to evaluate long-term outcomes. This abstract is funded by: None
Patel et al. (Fri,) studied this question.