Sotatercept for the Treatment of Pulmonary Arterial Hypertension

The characteristic of pulmonary arterial hypertension is cellular proliferation, pulmonary vascular remodeling, and poor long-term outcomes. Sotatercept is a novel fusion protein that binds activins and growth differentiation factors with an aim to restore the balance between growth-promoting and growth-inhibiting signaling pathways. Marc Humbert and colleagues conducted research under the title “Sotatercept for the Treatment of Pulmonary Arterial Hypertension” published in the New England Journal of Medicine. The summary of this article is given below:
Objective:
To investigate the effect of sotatercept in the treatment of pulmonary arterial hypertension.
Method:
It is a multicenter trial with 106 participants randomly assigned to receive subcutaneous sotatercept at a dose of 0.7 mg per kg of body weight every 3 weeks or 0.3 mg per kg every 3 weeks or placebo for pulmonary arterial hypertension treatment for 24-weeks. The main outcome was the transition on pulmonary vascular resistance from baseline to week 24.
Findings:
Sotatercept resulted in a greater significant reduction in pulmonary vascular resistance by decreasing the mean pulmonary artery pressure, without making a substantial difference in cardiac output or pulmonary artery wedge pressure. There was an improvement in exercise capacity as well as NT-proBNP levels from baseline with sotatercept. The most common adverse events observed were thrombocytopenia and an elevated hemoglobin level.
Limitations:
The study has a relatively less sample size. Additionally, the long-term effect of sotatercept have not been studied. Lastly, the study was not designed to observe sotatercept effect on clinical outcomes such as mortality.
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