Evidence map›Paper›PMID 42266819›Full record

ArticlePulmonary circulation2026

A Multicenter, Double-Blind, Placebo-Controlled, Randomized Clinical Trial of Oral Anticoagulation in Systemic Sclerosis-Related Pulmonary Arterial Hypertension-Results From the SPHInX Study.

Mandana Nikpour, Alicia Calderone, Susanna M Proudman, Dylan Hansen, Eli Gabbay, Nathan Dwyer, Gregory Keir, Vivek Thakkar, Peter K K Wong, Anne Keogh and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pulmonary circulation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

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

17 authors.

Mandana NikpourThe University of Sydney School of Public Health Sydney New South Wales Australia.
Alicia CalderoneDepartment of Rheumatology St. Vincent's Hospital Melbourne Fitzroy Victoria Australia.
Susanna M ProudmanAdelaide Medical School University of Adelaide Adelaide South Australia Australia.
Dylan HansenDepartment of Rheumatology St. Vincent's Hospital Melbourne Fitzroy Victoria Australia.
Eli GabbayRespiratory Medicine Clinic St John of God Subiaco Hospital Subiaco Western Australia Australia.
Nathan DwyerDepartment of Cardiology Royal Hobart Hospital Hobart Tasmania Australia.
Gregory KeirDepartment of Respiratory and Sleep Medicine Princess Alexandra Hospital Woolloongabba Queensland Australia.
Vivek ThakkarDepartment of Rheumatology Liverpool Hospital Liverpool New South Wales Australia.
Peter K K WongDepartment of Rheumatology Westmead Hospital Westmead New South Wales Australia.ORCID https://orcid.org/0000-0002-2182-1815
Anne KeoghHeart Transplant Unit, St Vincent's Hospital Sydney Darlinghurst New South Wales Australia.
Andrew BurnsDepartment of Medicine at St. Vincent's Hospital University of Melbourne Fitzroy Victoria Australia.
David PriorDepartment of Medicine at St. Vincent's Hospital University of Melbourne Fitzroy Victoria Australia.
Harshal NandurkarClinical Haematology, Alfred Health Melbourne Victoria Australia.
David S CelermajerSydney Medical School University of Sydney Camperdown New South Wales Australia.
Joanne SahharDepartment of Rheumatology Monash Health Clayton Victoria Australia.
Rachelle BuchbinderMusculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia.
Wendy StevensDepartment of Rheumatology St. Vincent's Hospital Melbourne Fitzroy Victoria Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The SPHInX study is the first-ever randomized controlled trial (RCT) seeking to inform an area of equipoise regarding the efficacy of oral anticoagulation as adjunct therapy in systemic sclerosis-related pulmonary arterial hypertension (SSc-PAH). The SPHInX study was an Australian multicenter, double-blind Phase III RCT of 1:1 oral apixaban 2.5 mg twice daily versus placebo over 3 years, as additional therapy in patients with SSc-PAH. The primary end-point was time to clinical worsening (TtCW), or death. A sample size of 85 per arm was required to show a two-fold reduction in TtCW. Participants experiencing clinical worsening events continued in the study, allowing for assessment of exploratory endpoints (including physical function and quality of life measures) up until 3 years of treatment. Among 11 SSc-PAH participants assigned apixaban treatment and 14 participants assigned placebo, apixaban demonstrated no benefit compared to placebo for TtCW from commencement until 30 days after discontinuation of study drug, Cox proportional hazard ratio 0.92 (95% confidence interval 0.32-2.66),

Indexed as

autoimmuneconnective tissue diseasetherapeutics

Identifiers

PMID42266819
PMCPMC13244262

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.