Sotatercept treatment in PAH patients was not associated with clinically significant weight gain, showing an overall mean weight change of -1.38 kg (95% CI -3.47 to 0.70; p=0.184).
Cohort (n=24)
No
Does sotatercept therapy cause clinically significant weight gain in patients with pulmonary arterial hypertension?
Sotatercept treatment in PAH patients is not associated with clinically significant weight gain, and may reduce diuretic dependence.
p-value: p=0.184
Abstract Background Patient-reported weight gain has emerged as a concern following Sotatercept initiation in pulmonary arterial hypertension (PAH). However, systematic longitudinal data are limited. We aimed to objectively assess weight trends and changes in medication use among PAH patients treated with Sotatercept to address concerns regarding treatment-associated weight gain. Methods This retrospective cohort study included 24 PAH patients who initiated Sotatercept therapy between August 2024 and July 2025 at a single academic center. Of 46 patients screened, 22 were excluded (death, n = 3; medication intolerance, n = 7; insufficient weight data, n = 12). Weight measurements were extracted from electronic medical records at baseline (≤90 days before first dose) and approximately 3, 6, and 9 months post-initiation using predefined time windows (0-4.5, 5-7, and 8-10 months, respectively). One measurement per timepoint per patient was selected as the closest to each target window. Concomitant PAH and diuretic medication use was recorded before and after treatment. Paired t-tests evaluated weight changes, and McNemar’s test assessed changes in medication use. Analyses were performed using IBM SPSS Statistics Version 29, with p 0.05 considered significant. Results The cohort was predominantly female (83%, n = 20) and Hispanic/Latino (58%, n = 14), with mean age 51.3 ± 16.7 years and baseline weight 79.9 ± 21.3 kg. Median follow-up was 170 days (IQR 130-267). Mean weight change from baseline was +0.11 ± 3.78 kg at 3 months (n = 24), +1.25 ± 4.36 kg at 6 months (n = 15), and +0.29 ± 2.12 kg at 9 months (n = 9). The overall mean change was −1.38 ± 4.94 kg (95% CI, −3.47 to 0.70; p = 0.184). Most patients maintained stable weight (±2 kg) across timepoints, while 12.5% experienced 5 kg loss and none had 5 kg gain. Diuretic use decreased from 66.7% to 45.8% (p = 0.125), and 25% discontinued diuretics. Prostacyclin de-escalation occurred in 5 of 11 patients (45.5%), including 2 IV-to-oral transitions, 2 dose reductions, and 1 discontinuation. No patient required PAH therapy escalation. Conclusions Objective longitudinal data indicate that Sotatercept treatment is not associated with clinically significant weight gain in PAH patients. Minimal mean weight changes and reduced diuretic dependence suggest improved volume status rather than fluid retention. Prospective studies are required to elucidate the perception of weight gain in these patients. This abstract is funded by: None
Estrada et al. (Fri,) conducted a cohort in Pulmonary Arterial Hypertension (PAH) (n=24). Sotatercept was evaluated on Overall mean weight change from baseline (95% CI -3.47 to 0.70, p=0.184). Sotatercept treatment in PAH patients was not associated with clinically significant weight gain, showing an overall mean weight change of -1.38 kg (95% CI -3.47 to 0.70; p=0.184).