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Multicenter Study
. 2021 Apr 21;21(1):130.
doi: 10.1186/s12890-021-01499-2.

Monotherapy in patients with pulmonary arterial hypertension at four German PH centres

Beate Stubbe  1 , Hans-Jürgen Seyfarth  2 , Janina Kleymann  3 , Michael Halank  3 , Hussam Al Ghorani  4 , Anne Obst  5 , Susanna Desole  5 , Ralf Ewert  5 , Christian F Opitz  4
Affiliations
Multicenter Study

Monotherapy in patients with pulmonary arterial hypertension at four German PH centres

Beate Stubbe et al. BMC Pulm Med. .

Abstract

Background: Although combination therapy is the gold standard for patients with pulmonary arterial hypertension (PAH), some of these patients are still being treated with monotherapy.

Methods: We conducted a retrospective analysis at four German PH centres to describe the prevalence and characteristics of patients receiving monotherapy.

Results: We identified 131 incident PAH patients, with a mean age of 64 ± 13.8 years and a varying prevalence of comorbidities, cardiovascular risk factors and targeted therapy. As in other studies, the extent of prescribed PAH therapy varied with age and coexisting diseases, and younger, so-called "typical" PAH patients were more commonly treated early with combination therapy (48% at 4-8 months). In contrast, patients with multiple comorbidities or cardiovascular risk factors were more often treated with monotherapy (69% at 4-8 months). Survival at 12 months was not significantly associated with the number of PAH drugs used (single, dual, triple therapy) and was not different between "atypical" and "typical" PAH patients (89% vs. 85%).

Conclusion: Although "atypical" PAH patients with comorbidities or a more advanced age are less aggressively treated with respect to combination therapy, the outcome of monotherapy in these patients appears to be comparable to that of dual or triple therapy in "typical" PAH patients.

Keywords: Combination therapy; Comorbidities; Monotherapy; Pulmonary arterial hypertension (PAH); Survival.

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Conflict of interest statement

Not applicable.

Figures

Fig. 1
Fig. 1
Duration of targeted treatment
Fig. 2
Fig. 2
Survival curves under PAH treatment with confidence intervals
Fig. 3
Fig. 3
Survival curves of typical and atypical patients with confidence intervals
Fig. 4
Fig. 4
Survival curves in atypical PAH patients on monotherapy versus combination therapy
See this image and copyright information in PMC

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