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In the last decade, several oral agents have become available for treating patients with pulmonary arterial hypertension (PAH). The newest such agent is selexipag (Uptravi; FDA-approved December 21, 2015), an oral selective intrapulmonary prostacyclin-receptor agonist. Selexipag potentially could delay initiation of therapy with intravenous (IV) prostacyclin. In this study, investigators report the results of an industry-sponsored, multicenter trial of selexipag versus placebo in 1156 patients with PAH. At baseline, about 80% of patients were taking endothelin-receptor antagonists, phosphodiesterase type 5 inhibitors, or both.
During treatment (median duration, ≈1 year), the composite endpoint of death from any cause or a PAH-related complic…