Data suggest benefits of PAH triple combination therapy

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A new paper, published Oct. 5, 2023, in the online journal Therapeutic Advances in Respiratory Disease, reveals an improvement in lung and heart function for pulmonary arterial hypertension (PAH) patients treated with a triple combination therapy. Researchers involved in this recent study found that the triple therapy predominantly reduced disease severity and improved survival. 

Previously, data on the long-standing efficacy of sequential triple combination therapy for PAH patients has been insufficient. Investigators at New York University (NYU) and West Virginia University conducted a study to help bolster research in this area. Authors of the paper confirmed “a sustained and long-term clinical and survival benefit.”

The retrospective observational study included a racially and ethnically diverse group of PAH patients at the NYU Langone Health Pulmonary Hypertension Center from January 2017 to July 2021. The intermediate- to high-risk participants initially were on an established dual therapy program and, after failing to improve, switched to the triple therapy regimen. 

Onset of the triple combo therapy occurred approximately 2.3 years following initial diagnosis. According to the paper, researchers examined “interval change in functional, echocardiographic and hemodynamic parameters, REVEAL 2.0 risk category and ERS/ESC 2022 simplified four-strata risk category.” 

After an average 1.3 years of follow-up, results indicated that patients who attained or maintained low-risk status significantly improved their long-term survival. Female gender predicted a higher probably of risk reduction, while Hispanic ethnicity predicted a lower probability of risk reduction. The cohort of participants generally tolerated the therapeutic regimen, however there was a noticeable uptick in gastrointestinal side effects. 

Although overall outcomes support long-term effectiveness of the triple combination therapy to treat PAH, larger studies, continuous monitoring and further exploration are necessary to regulate and uphold the approach. 

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