Can a “Ligand Trap” Finally Bend the Mortality Curve in Advanced PAH?

When added to maximal therapy, sotatercept significantly reduced risk for death, transplantation, or hospitalization in a high-risk population.

Despite treatment with triple-vasodilator regimens, advanced pulmonary arterial hypertension (PAH) remains lethal. In a previous manufacturer-funded trial, the addition of sotatercept (a fusion protein that binds the ligand activin) to standard regimens improved functional outcomes and reduced risk for clinical worsening in patients with moderate to advanced PAH (NEJM JW Cardiology Mar 23 2023 and N Engl J Med 2023; 388:1478). Now, researchers have examined its effect on major clinical endpoints in patients with more-advanced PAH (NCT04896008).

This manufacturer-funded, double-blind study included 172 adults with WHO functional class III–IV PAH and high 1-year mortality risk (REVEAL-Lite 2 risk score ≥9). All patients were on maximally toler…

Reviewing Author

Vlad G. Zaha, MD, PhD, FACC, FAHA

Disclosures

Grant/Research SupportCancer Prevention and Research Institute of Texas; National Institute of Health

Editorial BoardsCirculation

Leadership Positions in Professional SocietiesTexas Chapter of the American College of Cardiology (Section Chair, Cardio-Oncology)

Vlad G. Zaha, MD, PhD, FACC, FAHA

Disclosures

Grant/Research SupportCancer Prevention and Research Institute of Texas; National Institute of Health

Editorial BoardsCirculation

Leadership Positions in Professional SocietiesTexas Chapter of the American College of Cardiology (Section Chair, Cardio-Oncology)

Can a “Ligand Trap” Finally Bend the Mortality Curve in Advanced PAH?

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Reviewing Author