Role of Selexipag in COPD Patients with out of Proportion Pulmonary Hypertension

Abstract

Background Pulmonary hypertension (PH) in patients with COPD is associated with an increase in the risk of COPD exacerbation, increased hospitalization and worse survival in this patient population. The majority of patients with COPD have a mild degree of pulmonary hypertension (with mean pulmonary artery pressure, mPAP Hypothesis Selexipag improves functional capacity in COPD patients with out of proportion pulmonary hypertension. Methods We reviewed the medical records of COPD patients who were started on selexipag for out of proportion pulmonary hypertension. The patients were diagnosed with COPD according to their history, pulmonary function tests and chest imaging. All patients had a right heart catheterization done at baseline that showed pulmonary hypertension with mPAP ≥ 35 mmHg at rest. Six-minute walk test was done at baseline and repeated at 6 months (+/- 2 months) after starting selexipag. Results Out of the six patients included in this study, five patients showed improvement of 6-minute walk distance (from 512 feet to 681 feet, mean change 169 feet) while 1 patient worsened (from 1177 feet to 913 feet). Conclusions In this case series of COPD patients with out of proportion pulmonary hypertension, the use of selexipag was associated with an improvement in functional status at 6 months. Larger size prospective studies are needed to confirm the findings.