Expert consensus on selexipag in pulmonary arterial hypertension


  • Dawn O'Shea
  • Univadis Medical News
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A panel of experts has recommended that selexipag may be considered for patients with pulmonary arterial hypertension (PAH) receiving dual oral endothelin receptor antagonist and phosphodiesterase type 5 inhibitor therapy in the following scenarios:

Idiopathic, heritable, drug- or toxin-induced or repaired congenital heart disease-associated pulmonary arterial hypertension (IPAH+):

Functional class (FC) II symptoms

low-risk haemodynamic parameters:

  • no hospitalisation for PAH in the last six months (hereto referred to as hospitalisation), moderate-to-severe right ventricular (RV) dysfunction, irrespective of N-terminal prohormone B-type natriuretic peptide (BNP/NT-proBNP levels) or six-minute walk distance (6MWD).
  • with hospitalisation, irrespective of all three measures.

intermediate risk:

  • irrespective of hospitalisation, irrespective of all three measures.

FC III symptoms

low risk:

  • irrespective of hospitalisation, irrespective of measures.

intermediate risk:

  • no hospitalisation, irrespective of measures.
  • with hospitalisation, normal/mildly impaired RV function, irrespective of BNP/NT-proBNP or 6MWD.

Connective tissue disease (CTD)-associated PAH

FC II symptoms

low-risk:

  • no hospitalisation, any degree of RV dysfunction, abnormal BNP/NT-proBNP, irrespective of 6MWD.
  • with hospitalisation, irrespective of measures.

intermediate risk:

  • irrespective of hospitalisation, irrespective of measures.

FC III symptoms

low risk:

  • no hospitalisation, abnormal RV function and BNP/NT-proBNP or 6MWD ≤440 m.
  • with hospitalisation, irrespective of measures.

intermediate risk:

  • no hospitalisation, irrespective of measures.
  • with hospitalisation, normal/mildly impaired RV function, irrespective of BNP/NT-proBNP or 6MWD.