Upfront triple combination therapy with selexipag: insights from a real world cohort in Chinese patients with pulmonary arterial hypertension.

Aim: Selexipag has demonstrated safety and efficacy in the treatment of pulmonary arterial hypertension (PAH). However, the strategy of triple therapy involving selexipag and its impact on right heart remodeling requires further clarification in Chinese patients with PAH. Methods and results: This investigation was conducted as a single-center, retrospective study. Patients with PAH who presented to Qilu Hospital of Shandong University from February 2022 to November 2023 with a definitive diagnosis of Group 1 PAH and who received a triple targeted therapy based on selexipag were included for a safety and efficacy evaluation. Data for the French pulmonary hypertension network non-invasive risk assessment, echocardiogram parameters, and clinical data were collected. Comparisons between initial and early sequential triple combination were conducted. A total of 153 patients were entered into the safety analysis and 146 patients were included in the efficacy analysis. No unknown side effects were reported. After selexipag treatment for 29 weeks in median, 96 (65.8%) reached WHO FC II compared to 39 (26.7%) at baseline ( Conclusion: Triple-targeted drug therapy containing selexipag can be safely and effectively used in Chinese PAH patients, significantly enhancing exercise capacity, improving right heart structure and function, and optimizing risk stratification. Selexipag-based initial triple therapy may offer demonstrable benefits for long term prognosis.