Inhaled treprostinil cuts mortality among patients of pulmonary hypertension associated with ILD: Study

Written By :  Dr. Shravani Dali
Medically Reviewed By :  Dr. Kamal Kant Kohli
Published On 2024-04-07 15:00 GMT   |   Update On 2024-04-08 05:38 GMT
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Inhaled treprostinil cuts mortality among patients of pulmonary hypertension associated with interstitial lung disease suggests a study published in the BMJ thorax.

A post-hoc analysis of the INCREASE trial and its open-label extension (OLE) was performed to evaluate whether inhaled treprostinil has a long-term survival benefit in patients with pulmonary hypertension associated with interstitial lung disease (PH-ILD). Two different models of survival were employed; the inverse probability of censoring weighting (IPCW) and the rank-preserving structural failure time (RPSFT) models both allow construction of a pseudo-placebo group, thereby allowing for long-term survival evaluation of patients with PH-ILD receiving inhaled treprostinil. Time-varying stabilised weights were calculated by fitting Cox proportional hazards models based on the baseline and time-varying prognostic factors to generate weighted Cox regression models with associated adjusted HRs.

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Results In the INCREASE trial, there were 10 and 12 deaths in the inhaled treprostinil and placebo arms, respectively, during the 16-week randomised trial. During the OLE, all patients received inhaled treprostinil and there were 29 and 33 deaths in the prior inhaled treprostinil arm and prior placebo arm, respectively. With a conventional analysis, the HR for death was 0.71 (95% CI 0.46 to 1.10; p=0.1227). Both models demonstrated significant reductions in death associated with inhaled treprostinil treatment with HRs of 0.62 (95% CI 0.39 to 0.99; p=0.0483) and 0.26 (95% CI 0.07 to 0.98; p=0.0473) for the IPCW and RPSFT methods, respectively. Two independent modelling techniques that have been employed in the oncology literature both suggest a long-term survival benefit associated with inhaled treprostinil treatment in patients with PH-ILD.

Reference:

Nathan SD, Johri S, Joly JM, et alSurvival analysis from the INCREASE study in PH-ILD: evaluating the impact of treatment crossover on overall mortalityThorax 2024;79:301-306.

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Article Source : BMJ Thorax

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