Evidence map›Paper›PMID 41653169›Full record

ArticleJACC. Asia2026

Ambrisentan for Early-Stage Low-Risk Pulmonary Arterial Hypertension: Design of the Randomized, Double-Blind, Placebo-Controlled ALEPH Trial.

Jun-Yan Kan, Xiao-Juan Zhang, Wan-de Yu, Zhen-Wen Yang, Fen-Ling Fan, Guan-Wen Ding, Jie Luo, Wei Li, Du-Jiang Xie, Xiao-Feng Liu and 2 more

Registry-linked trialAbstract read
In one paragraph

Article in JACC. Asia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06987097 (Ambrisentan for the Treatment of Early-Stage Low-Risk Pulmonary Arterial Hypertension), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06987097 nanot yet recruitingnot on this map

Ambrisentan for the Treatment of Early-Stage Low-Risk Pulmonary Arterial Hypertension: A Multicenter, Randomized, Double-Blind, Placebo-Controlled ALEPH Trial

TypeinterventionalSponsorNanjing First Hospital, Nanjing Medical UniversityRan2025 to 2029Enrolled410ConditionsPulmonary Arterial Hypertension (PAH)ArmsAmbrisentan, Placebo
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jun-Yan KanDepartment of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Xiao-Juan ZhangDepartment of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Wan-de YuDepartment of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Zhen-Wen YangDepartment of Cardiology, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China.
Fen-Ling FanDepartment of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an Jiaotong University, Xi'an, China.
Guan-Wen DingDepartment of Biology, Emory University, Atlanta, USA.
Jie LuoDepartment of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Wei LiDepartment of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Du-Jiang XieDepartment of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Xiao-Feng LiuInternal Medicine Department, Haian Hospital of Traditional Chinese Medicine, Nantong, China.
Hang ZhangDepartment of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. Electronic address: dxh_nari@sina.com.
Shao-Liang ChenDepartment of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. Electronic address: chmengx@126.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly-stage pulmonary arterial hypertension (PAH) with mild hemodynamic abnormalities is increasingly being concerned because of the revised PAH definition. However, there is a lack of randomized controlled trials evaluating the efficacy of currently available medications in this population.

objectivesThe ALEPH (Ambrisentan for Early Low-Risk Pulmonary Arterial Hypertension) trial is designed to investigate the efficacy and safety of ambrisentan in early-stage low-risk PAH patients.

methodsThe ALEPH trial is a multicenter, randomized, double-blind, placebo-controlled clinical study. Eligible patients are diagnosed with PAH according to 2022 European Society of Cardiology and the European Respiratory Society guidelines, with mean pulmonary artery pressure >20 and <25 mm Hg, pulmonary vascular resistance >2 and ≤3 WUs, and PAWP ≤15 mm Hg by right heart catheterization, classified as low-risk, and have not previously received PAH-specific therapy. Participants are randomly assigned to receive either ambrisentan or placebo for 12 months. The primary endpoint is a composite of PAH progression. Secondary endpoints include changes in hemodynamic and echocardiographic parameters, N-terminal pro-B-type natriuretic peptide levels, World Health Organization functional class, 6-minute walk distance, and time to clinical events such as hospitalization or death. Primary analysis will be performed in the intention-to-treat population, with sensitivity analysis in the per-protocol population. Statistical analyses include Z-test for the primary endpoint, Cox proportional hazards models for time-to-event data, and analysis of covariance or Mann-Whitney U test for continuous variables.

conclusionsThe ALEPH trial aims to generate high-quality evidence regarding the efficacy and safety of ambrisentan monotherapy in early-stage, low-risk PAH. This study may provide valuable insight into early therapeutic intervention for patients with mild hemodynamic disorder. (Ambrisentan for Early Low-Risk Pulmonary Arterial Hypertension [ALEPH]; NCT06987097).

Indexed as

ambrisentanendothelin receptor antagonistplacebopulmonary arterial hypertensionworsening

Identifiers

PMID41653169
PMCPMC13153902

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.