Top 5 Most-Read PAH Articles of 2021

This year’s most-read articles on pulmonary arterial hypertension (PAH) covered a range of topics, including nutrition, therapy switches, and patient education to improve treatment adherence. Improving patient outcomes is something they all had in common.

The topics that garnered the most attention on our pulmonary arterial hypertension (PAH) compendium page this year covered investigations into the effects of nutritional risk and oxygen therapy among patients with PAH, transitioning between treatment regimens, the importance of patient education, and real-world data on selexipag.

Here are the 5 most-read PAH articles of 2021.

5. Assessing Nutritional Risk Can Predict PAH Prognosis at First Hospitalization

In this article from April, the Geriatric Nutritional Risk Index showed promise as a predictive prognosis tool among hospitalized patients who have PAH or chronic thromboembolic pulmonary hypertension (CTEPH). Undernutrition was cited as a potential trigger for disease progression among patients with precapillary pulmonary hypertension, of which PAH and CTEPH are subtypes. In addition, because both weight loss and undernutrition are common in PAH and CTEPH, the authors suggest that further studies address nutritional interventions among persons with the conditions.

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4. Patients With PAH Can Safely Transition From Bosentan and Sildenafil to Alternative Therapy

With drug-drug interactions possible among patients with PAH on a treatment regimen of bosentan and sildenafil, switching from the endothelin receptor antagonist/phosphodiesterase type 5 inhibitor combination to an alternative therapy may be necessary, according to this June article covering a retrospective study. The aim of such a move would be to improve combination therapy efficacy, the study authors noted, with future studies also investigating the effects of such a move on clinical outcomes and hemodynamics.

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3. Oxygen Has Potential Benefits as a Therapy for Pulmonary Arterial Hypertension

Oxygen therapy may improve outcomes among patients with PAH beyond those who develop hypoxemia, or low oxygen blood levels, according to this summary of the findings of a European Journal of Preventive Cardiology article from March. Several studies they reviewed highlighted such potential benefits as pulmonary hemodynamics, echocardiographic measurements, and 6-minute walk distance, while also challenging the therapy’s clinical effectiveness and noting its high costs.

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2. Educational Support Can Improve Compliance to Oral PAH Therapies

With tolerance and compliance noted as chief challenges to medication adherence, this study covered in an April article investigated outcomes following an educational nursing program administered among patients taking oral therapies for PAH. Comparing outcomes with patients not supported by the program, the disease state education, therapy expectations, and support tools provided within the program were shown to lead to higher prescription fill count, medication possession ratio, and therapy persistence, but lower first fill drop-off rate.

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1. SPHERE Registry Provides Snapshot of Selexipag to Treat PAH in the Real World

This registry of 500 patients with PAH undergoing treatment with the prostacyclin agonist selexipag provides important real-world data on clinical characteristics, dosing regimens, and clinical outcomes for those on the drug, as noted in this April article. Originally approved by the FDA in 2015, selexipag was shown to primarily be used among patients with World Health Organization functional class II/III disease and who were at intermediate risk. The US-based observational drug registry has a target enrollment of 800 patients.

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