Haemodynamic effects of riociguat in CTEPH and PAH: a ten-year observational study
- Suqiao Yang1,2,3,
- Yuanhua Yang1,2,3⇑,
- Yixiao Zhang1,2,3,
- Tuguang Kuang1,2,3,
- Juanni Gong1,2,3,
- Jifeng Li1,2,3,
- Yidan Li4,
- Jianfeng Wang5,
- Xiaojuan Guo5 and
- Ran Miao3,6
- 1Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- 2Beijing Institute of Respiratory Medicine, Beijing, China
- 3Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing, China
- 4Department of Echocardiography, Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- 5Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- 6Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- Yuan-hua Yang (yyh1031{at}sina.com)
Abstract
Background Long-term treatment with riociguat has been shown to enhance exercise capacity in patients of pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH). This study sought to evaluate the long-term haemodynamic effects of riociguat in patients of PAH and inoperable CTEPH.
Methods During this single-center long-term observational study, riociguat was administered at a three-times-daily dose of up to 2.5 mg. The primary outcome was pulmonary vascular resistance (PVR). The secondary outcomes included mean pulmonary arterial pressure (PAP), cardiac index (CI), mortality, clinical worsening events, 6-min walking distance (6 MWD), and World Health Organization functional class (WHO FC).
Results 37 patients (CTEPH, n=19; PAH, n=18) were included. The median follow-up period was 96 months. The survival estimates for all the patients at 1/3/5/8 year were 0.97/0.86/0.72/0.61, without significant difference between patients with CTEPH and PAH. At the final data cut-off, PVR decreased (1232±462 dyn·s·cm–5 versus 835±348 dyn·s·cm–5, p<0.001), CI increased (1.7±0.4 L·min−1·m−2 versus 2.4±0.5 L·min−1·m−2, p<0.001), 6 MWD increased by 43.1±59.6 m, and WHO FC improved/stabilised/worsened in 40/35/25% of patients versus baseline. Improvement in PAP was not shown. Compared with patients in WHO FC I/II and III/IV at baseline, the 8-year clinical worsening-free survival estimates were 0.51 versus 0.19 (p=0.026).
Conclusions Riociguat improved PVR and CI for up to 8 years, but not PAP. WHO FC may have certain predictive value for the long-term prognosis.
Footnotes
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Conflict of interest: Dr. Yang has nothing to disclose.
Conflict of interest: Dr. Yang has nothing to disclose.
Conflict of interest: Miss. Zhang has nothing to disclose.
Conflict of interest: Dr. Kuang has nothing to disclose.
Conflict of interest: Dr. Gong has nothing to disclose.
Conflict of interest: Dr. Li has nothing to disclose.
Conflict of interest: Dr. Li has nothing to disclose.
Conflict of interest: Dr. Wang has nothing to disclose.
Conflict of interest: Dr. Guo has nothing to disclose.
Conflict of interest: Dr. Miao has nothing to disclose.
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- Received January 31, 2021.
- Accepted June 28, 2021.
- Copyright ©The authors 2021
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