Ambrisentan plus Tadalafil Might Benefit Patients with Early Pulmonary Arterial Hypertension

Most patients in whom pulmonary arterial hypertension (PAH) is diagnosed are initially prescribed a single therapeutic agent. Eventually, many patients will receive multiple medications, with each affecting a different physiologic pathway. So, would PAH patients be better off receiving two drugs from the beginning?

Investigators randomized 500 PAH patients (mean age, 54) with WHO class II or III symptoms to receive daily ambrisentan (Letairis; 10 mg), tadalafil (Adcirca; 40 mg), or both drugs. Half of enrollees had idiopathic PAH.

The hazard ratio for the combined primary endpoint (death, hospitalization for worsening pulmonary arterial hypertension, disease progression, or unsatisfactory long-term clinical response) was 0.50 in the combinati…