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Incident pulmonary arterial hypertension associated with greater risk for disease progression

Patients with incident pulmonary arterial hypertension appeared to have a higher risk for disease progression, according to recent research.

However, these patients had the same all-cause mortality risk as patients with prevalent pulmonary arterial hypertension.

“In this post hoc analysis of treatment-naive patients in the SERAPHIN study, a greater proportion of incident patients experienced disease progression events compared with prevalent patients, yet there was no difference in the risk of all-cause death between the cohorts,” Gérald Simonneau, MD, of the Assistance Publique–Hôpitaux de Paris at the Service de Pneumologie, Hôpital Bicêtre; Université Paris-Sud in Le Kremlin-Bicêtre, France, and colleagues wrote. “The differences in disease progression were observed despite there being no clinically significant differences in baseline hemodynamics between the incident and prevalent cohorts.”

Simonneau and colleagues evaluated 257 patients enrolled in the Study with an Endothelin Receptor Antagonist in Pulmonary Arterial Hypertension to Improve Clinical Outcome (SERAPHIN) study and divided them into incident (≤ 6 months; n = 110 patients) and prevalent (> 6 months; n = 157 patients) groups based on their time to diagnosis, according to the abstract. The researchers then assigned patients either 3 mg or 10 mg of macitentan, or placebo. They used a Cox regression analysis to determine mortality or hospitalization due to pulmonary arterial hypertension as well as risk for morbidity or mortality in these groups.

Researchers found patients in the incident group had a greater risk for morbidity or mortality, (Kaplan-Meier estimates at month 12, 54.4% vs. 26.7%) among patients assigned to placebo (P = .006). Further, the Kaplan-Meier estimated risk for mortality or hospitalization related to pulmonary arterial hypertension was also higher at month 12 for patients in the incident group (47.3%) compared with prevalent patients (19.9%) among patients assigned placebo (P = .006), according to the abstract.

Simonneau and colleagues noted that 10 mg of macitentan significantly improved the mortality risk due to pulmonary arterial hypertension in both incident and prevalent groups when compared with the placebo group; however, there was no significant difference in all-cause mortality risk for either group. – by Jeff Craven

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