Photo Credit: Rasi Bhadramani

The following is a summary of “Parenteral prostacyclin utilization in patients with pulmonary arterial hypertension in the intermediate-risk strata: a retrospective chart review and cross-sectional survey,” published in the November 2024 issue of Pulmonology by Vaidya et al. 

Current guidelines recommend parenteral prostacyclin therapy for individuals with pulmonary arterial hypertension (PAH) at intermediate risk.  

Researchers conducted a retrospective study to evaluate parenteral prostacyclin therapy use among individuals at intermediate risk based on the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension COMPERA 2.0 four-strata risk model.  

They reviewed an online survey involving healthcare professionals (HCPs). Individuals included were categorized as intermediate-low or intermediate-high risk per COMPERA 2.0 between 2016 and 2020 (index visit), initiated parenteral prostacyclin therapy after intermediate risk classification, and had assessments of World Health Organization (WHO) Functional Class (FC), 6-minute walk distance (6MWD), and B-type natriuretic peptide/N-terminal pro B-type natriuretic peptide (BNP/NT-proBNP) at both index and follow-up visits (first comprehensive follow-up).  

The results showed 139 healthcare professionals (HCPs), including 53% from community-based practices and 47% from Pulmonary Hypertension Care Centers, participated in the survey and contributed 350 records. The mean age of individuals was 54.1 years (SD 15.3), with 52% female. The median time (IQR) from initiating parenteral prostacyclin therapy to follow-up was 3.0 months (2.0, 7.0). Among 280 records with available COMPERA 2.0 assessments at therapy initiation, 62% were classified as intermediate-high risk, 33% as intermediate-low risk, and 3% as low risk, improving at follow-up to 38%, 53%, and 8%, respectively.  

Investigators concluded that improvements were seen for individual COMPERA 2.0 risk calculator parameters and several other clinical parameters, and findings from this study substantiated recent guidelines suggesting earlier use of this treatment in intermediate-risk patients with PAH. 

Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-03388-w