Fixed-dose combination pill outperforms monotherapy for pulmonary hypertension (Macitentan & tadalafil)

Medical Xpress / American College of Cardiology's Annual Scientific Session ^ | March 7, 2023 | Kelly Chin, MD et al

[ConservativeMind]

Patients with pulmonary arterial hypertension (high blood pressure in the arteries that supply the lungs, also called PAH) had approximately double the reduction in pulmonary vascular resistance (PVR) if they took the PAH medications macitentan (10 mg) and tadalafil (40 mg) together in a single tablet rather than either drug alone, according to research.

Macitentan and tadalafil are among several drugs approved by the U.S. Food and Drug Administration for the treatment of PAH. Guidelines and previous studies suggest that using two or more agents to treat PAH can bring extra benefits. In the portion of the study that compared the fixed-dose combination with macitentan monotherapy, PVR decreased by 45% in the fixed-dose combination arm and by 23% in the monotherapy arm. In a comparison with tadalafil monotherapy, PVR decreased by 44% in the fixed-dose combination arm and 22% in the monotherapy arm.

PAH is a rare condition that restricts the flow of blood from the heart to the lungs, which reduces the amount of oxygen carried in the blood. There is currently no cure.

At week 16, participants taking the two-drug combination tablet showed a significantly greater reduction in PVR compared to baseline than participants taking either drug alone, meeting the trial's primary endpoint.

"Across many studies, we're seeing that more is better in terms of lowering PVR, and what we get with one medication is, for many patients, just not enough," Chin said. "I would strongly recommend combination therapy with two medications initially for the majority of patients, and this combination has significant evidence that it's effective and well tolerated."

Patients taking the two-drug combination therapy were more likely to discontinue their assigned therapy due to adverse events, with anemia, hypotension (low blood pressure) and swelling being the most common side effects.

[ConservativeMind]

More side effects were possible, but much better control.

[ConservativeMind]

The “Take Charge Of Your Health” Ping List
This high volume ping list is for health articles and studies which describe something you or your doctor, when informed, may be able to immediately implement for your benefit.

Email me to get on either the “Common/Top Issues” (20 - 25% fewer pings) or “Everything” list.

[Guenevere]

BTTT