Abstract 12978: Real-World Treatment Patterns in Hispanic and White Patients With Pulmonary Arterial Hypertension (PAH) in the United States

Abstract

Introduction: ESC/ERS guidelines recommend initial double oral combination therapy (endothelin-receptor antagonist plus phosphodiesterase 5 inhibitor) in low or intermediate risk PAH patients without cardiopulmonary comorbidities. Upfront use of prostacyclin pathway analogue (PPA) is recommended for patients with high risk of 1-year mortality. Few studies have evaluated treatment patterns/adherence in PAH patients across ethnic groups. Aims: To describe demographic/clinical characteristics and treatment patterns in US Hispanic and White PAH patients. Methods: A retrospective, observational, analysis using Optum’s de-identified Clinformatics ® Data Mart database identified patients aged ≥18 years with pulmonary hypertension (PH) diagnosis (excluding chronic thromboembolic PH) and were new users of PAH medications. Index date was the 31 st day after first PAH-specific medication use (1 Jan 2016-30 Jun 2022); the 30-day window between first PAH medication use and index date was used to identify the initial PAH regimen. Patient characteristics and PAH treatment patterns were analyzed descriptively, with standardized mean differences (SMD) between cohorts assessed (SMD >0.1 indicated significant difference). Results: Hispanic patients were younger, with lower income, lower education level, and higher comorbidity burden than White patients (Table). Few patients received initial combination PAH treatment with similar use of combination therapy in the two cohorts (~14% in each). Hispanic patients were less likely to receive a PPA-containing index treatment regimen and had lower index treatment adherence (Table). Conclusions: In Hispanic and White patients, index combination PAH therapy use was low. Hispanic patients were less likely to receive a PPA-containing index treatment and had lower index treatment adherence. Further research and awareness of the influence of ethnicity on treatment management is needed to improve PAH care.