In patients with unresectable chronic thromboembolic pulmonary hypertension (CTEPH), treatment with selexipag did result in a significant improvement in pulmonary vascular resistance (PVR) and other haemodynamic variables, with no effect on exercise capacity. This has emerged from a placebo-controlled trial from Japan.
There are few treatment options for patients with unresectable CTEPH. The oral selective IP prostacyclin receptor agonist selexipag is approved for pulmonary arterial hypertension (PAH) and represents a potential treatment option for CTEPH. This study enrolled 78 Japanese patients with unresectable CTEPH or persistent/recurrent pulmonary hypertension after pulmonary endarterectomy and/or balloon angioplasty. They were randomly assigned to placebo or selexipag.
The primary endpoint was the change in PVR between baseline and week 20. PVR decreased by a mean of 98.2 dyn s cm-5 in the selexipag group and with 4.6 dyn s cm-5 in the placebo group (p = 0.006). Changes in cardiac index (p < 0.001) and Borg dyspnea scale score (p = 0.036) were also significantly better with selexipag than with placebo. In contrast, 6-minute walking distance (6MWD) and WHO functional class were not significantly improved with selexipag relative to placebo.
The common adverse reactions in the selexipag group were consistent with those generally observed after administration of a prostacyclin analogue. Further large-scale research is needed to prove the role of selexipag in CTEPH, the researchers said.
Bron:
Ogo T, Shimokawahara H, Kinoshita H, et al. Selexipag for the treatment of chronic thromboembolic pulmonary hypertension. Eur Respir J. 2022;60:2101694.