The Clinical Experience of Macitentan in pulmonary hypertension in Indian cohort: 12-months follow-up

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. AIM AND OBJECTIVE Macitentan, an endothelin receptor antagonist, has been shown to be effective and safe in the treatment of pulmonary arterial hypertension (PAH) in multiple randomized clinical trials, including SERAPHIN, focusing on morbidity and mortality reduction. The goal of this study was to show the clinical and echocardiographic improvement with macitentan in Indian patients with PAH. METHODS We conducted a retrospective study of 20 patients with various etiologies of PAH who received macitentan treatment in a single institution between June 2018 and June 2019. Of the total cases, 55% of the patients took conventional PAH therapies. We assessed the World Health Organization functional class (WHO-FC), 6-minute walking distance (6MWD), N-terminal prohormone brain natriuretic peptide level (NT-pro-BNP), and echocardiographic data such as tricuspid annular plane systolic excursion (TAPSE), systolic pulmonary artery pressure (sPAP), and the presence of pericardial effusion at baseline and 12-month follow-up. RESULTS The study involved 20 PAH patients, 70 % of whom were female. The majority (50%) were in WHO FC II, while 35% were in FC III, and 15% were in FC IV. At the start of the macitentan therapy, the average age was 43.4 years. After 12-months of macitentan medication, 85% of patients showed significant improvement in their FC, 6-minute walking distance test (p < 0.0001; Fig.-1), and plasma levels of NT-pro BNP were significantly reduced (p < 0.0001). Echocardiographic parameters such as TAPSE and sPAP have also improved (p < 0.0001). CONCLUSION Our findings indicate that macitentan has been well-tolerated and beneficial in Indian patients with PAH, and further future research is required to verify these results. Abstract Figure.