Transforming Pulmonary Arterial Hypertension Management: Bridging Clinical Practice, Innovative Therapies, and Economic Impact
Ryan Haumschild, PharmD, MBA, MS; Sandeep Sahay, MD, FCCP; Murali Chakinala, MD, FCCP, and Marius M. Hoeper, MD, discuss how pulmonary arterial hypertension management has evolved with new therapeutic pathways like sotatercept offering reverse remodeling capabilities, requiring individualized treatment approaches that balance disease severity, patient preferences, and economic considerations while emphasizing early diagnosis and aggressive upfront combination therapy to achieve disease remission and reduce long-term healthcare costs.
Episodes
May 28th 2025EP. 1: Pathophysiology of Pulmonary Arterial Hypertension
Panelists discuss how the pathophysiology of pulmonary arterial hypertension involves complex mechanisms across multiple genetic and treatment pathways, with over 20 identified genes and four major therapeutic targets including nitric oxide, endothelin, prostacyclin, and activin signaling inhibition.
May 28th 2025EP. 2: Differential Diagnosis of Pulmonary Arterial Hypertension
Panelists discuss how pulmonary arterial hypertension diagnosis requires comprehensive evaluation including right heart catheterization to confirm hemodynamic criteria, with normal mean PA pressure being ≤20 mmHg and the need to rule out other causes of pulmonary hypertension.
June 6th 2025EP. 3: Importance of Early Detection and Monitoring for Disease Progression
Panelists discuss how early detection barriers include nonspecific symptoms like progressive dyspnea that are often misattributed to more common conditions, leading to delayed diagnosis and the need for improved diagnostic algorithms using biomarkers and imaging.
June 6th 2025EP. 4: The Importance of Patient-Centered Care
Panelists discuss how disease progression monitoring requires integrating multiple data points including symptoms, six-minute walk tests, biomarkers like BNP/NT-proBNP, and imaging studies, with risk stratification tools helping guide treatment decisions while considering individual patient characteristics.
June 12th 2025EP. 5: Strengths and Limitations of Current Therapeutic Options
Panelists discuss how treatment individualization depends on patient-specific factors including age, comorbidities, disease severity, and personal preferences, balancing clinical guidelines with shared decision-making to optimize both efficacy and adherence.
Panelists discuss how current therapeutic strengths include 15 approved treatments with different mechanisms of action that can work synergistically, while limitations involve variable delivery methods and complexity, leading to more aggressive upfront combination therapy approaches.
June 19th 2025EP. 7: Sotatercept for Patients with Pulmonary Arterial Hypertension
Panelists discuss how riociguat targets the nitric oxide pathway and is approved for both Group 1 PAH and Group 4 chronic thromboembolic pulmonary hypertension, with specific patient selection criteria based on risk stratification and surgical candidacy.
June 19th 2025EP. 8: Paradigm Shift in the Management of Pulmonary Arterial Hypertension
Panelists discuss how sotatercept represents a paradigm shift as the first activin signaling inhibitor showing dramatic improvements in heavily pretreated patients, with the Stellar and Zenith trials demonstrating significant reductions in clinical worsening and potential for reverse remodeling.
