Selexipag Shows Promise in Treating Pulmonary Arterial Hypertension

Recent findings from the 'SelexiPag: tHe usErs dRug rEgistry' (SPHERE) study reveal that individuals with pulmonary arterial hypertension (PAH) experienced positive outcomes with the oral prostacyclin receptor agonist selexipag.

The study was published in Journal Of Heart And Lung Transplantation. Led by Dr. Vallerie McLaughlin from the University of Michigan, this real-world analysis provides valuable insights into the effectiveness and usage of selexipag in treating PAH.

In this extensive study, researchers examined data from the SPHERE registry, a US-based prospective real-world registry of patients treated with selexipag. Key findings include:

• Real-World Outcomes: The study, conducted between November 2016 and March 2020, assessed real-world outcomes of adult PAH patients. It involved a follow-up period of up to 18 months.
• Newly Initiated vs. Previously Initiated: Patients were categorised as 'newly initiated' (beginning treatment within 60 days prior to enrollment) or 'previously initiated' (beginning over 60 days prior to enrollment).
  
• Risk Assessment: Researchers used the REVEAL 2.0 risk calculator to categorise patients' 1-year mortality risk as low, high, or intermediate at baseline.
  
• Registry Expansion: Originally targeting 500 individuals, the registry expanded to include 829 subjects, with a focus on newly-initiated patients. Among them, 55.6% were classified as World Health Organization functional class (FC) III/IV.
  
• Efficacy and Safety: Approximately 78% of PAH patients treated with selexipag maintained or reduced their 1-year mortality risk level (57% vs. 21%, respectively). The study highlighted the efficacy and safety of selexipag in real-world settings.
  
• Clinical Practice vs. Guidelines: Despite guideline recommendations, the study revealed a disconnect between clinical practice and guideline adherence. Many eligible patients received monotherapy or dual therapy instead of combination therapy.
  

The SPHERE study underscores the potential benefits of selexipag in managing PAH in real-world scenarios. It suggests that optimising titration earlier in treatment may be more effective than current practices. Additionally, the findings emphasise the need to address barriers to the clinical adoption of guideline recommendations to enhance healthcare for PAH patients.

Reference:

Vallerie McLaughlin, Harrison W. Farber, Kristin B. Highland, et al. Disease characteristics, treatments, and outcomes of patients with pulmonary arterial hypertension treated with selexipag in real-world settings from the SPHERE registry (SelexiPag: tHe usErs dRug rEgistry) Running title: Real-world data for selexipag in PAH patients, Journal of Heart and Lung Transplantation, (2023). doi:https://doi.org/10.1016/j.healun.2023.09.016