Comparing bridging drug therapy approaches prior to balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension: a prospective analysis from the national UK CURATE registry.
Evidence suggests dual therapy with phosphodiesterase-5 inhibitor and endothelin receptor antagonist provided superior hemodynamic improvements compared to monotherapy in adult CTEPH patients bridging to balloon pulmonary angioplasty. Signal observed for 40% increase in cardiac index and 39% reduction in pulmonary vascular resistance with dual therapy versus more modest improvements with PDE5i or riociguat monotherapy, without increased periprocedural complications. Worth noting this real-world registry data demonstrates efficacy of combination pulmonary hypertension therapies in the CTEPH population.
PDE5i and ERA dual therapy was associated with greater haemodynamic improvement than monotherapy with PDE5i or riociguat, without differences in complication rates.
Relevance: Study comparing bridging PH medical therapies (PDE5i, ERA dual therapy, riociguat) in chronic thromboembolic pulmonary hypertension before balloon angioplasty. Directly relevant to pulmonary hypertension research interest; however, focuses on adult CTEPH rather than pediatric congenital heart disease. Some drugs discussed (sildenafil is a PDE5i, similar mechanism) relate to profile formulary.