(selexipag)
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UPTRAVI® (selexipag)
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Comparison of UPTRAVI and Inhaled Treprostinil
Last Updated: 04/02/2024
SUMMARY
- A retrospective, multicenter, cohort study conducted at 2 tertiary medical centers between January 1, 2012, and June 30, 2019, compared treatment with UPTRAVI and inhaled treprostinil in patients diagnosed with pulmonary arterial hypertension (PAH). The primary endpoint was time to clinical worsening of PAH and was analyzed from initiation up to 18 months. The primary endpoint occurred in 21.7% (37/170) and 20.9% (17/81) of patients in the UPTRAVI and inhaled treprostinil groups, respectively.1
Retrospective study
A retrospective, multicenter, cohort study conducted at 2 tertiary medical centers between January 1, 2012, and June 30, 2019, compared treatment with UPTRAVI and inhaled treprostinil in patients diagnosed with PAH. The primary endpoint was time to clinical worsening of PAH (a composite of PAH-related hospitalization or initiation of a parenteral prostacyclin) and was analyzed from initiation up to 18 months.1 Information regarding the patient baseline characteristics is provided in Table: Baseline Characteristics.
| UPTRAVI (n=170) | Inhaled Treprostinil (n=81) | P-value | |
|---|---|---|---|
| Age (years), median (Q1, Q3) | 52.6 (43.0, 61.5) | 53.9 (44.8, 64.7) | 0.51 |
| Female, n (%) | 127 (74.7) | 55 (67.9) | 0.26 |
| Time from diagnosis to study drug (months), median (Q1, Q3) | 30.7 (9.5, 100.7) | 16.2 (3.8, 45.4) | <0.001 |
| WHO Functional Class, n (%) | |||
| I | 3 (1.8) | 1 (1.2) | 1 |
| II | 39 (23.0) | 13 (16.0) | 0.25 |
| III | 107 (63.0) | 62 (76.5) | 0.04 |
| IV | 15 (8.8) | 4 (5.0) | 0.32 |
| RHC data at time of PAH diagnosis, median (Q1, Q3) | |||
| mPAP (mmHg) | 53.5 (45, 62) | 51 (45, 60) | 0.31 |
| PCWP (mmHg) | 9 (7, 13) | 10 (7, 15) | 0.32 |
| PVR (woods units) | 10.3 (7.1, 13.8) | 10 (7.7, 13.3) | 0.91 |
| CI (L/min/m2 | 2.4 (1.8, 3.1) | 2.13 (1.7, 2.5) | 0.006 |
| PDE-5i, n (%) | |||
| Sildenafil | 59 (34.7) | 28 (34.6) | 0.52 |
| Tadalafil | 76 (44.7) | 41 (50.6) | |
| None | 35 (20.6) | 12 (14.8) | |
| ERA, n (%) | |||
| Ambrisentan | 50 (29.4) | 22 (27.2) | <0.0001 |
| Bosentan | 9 (5.3) | 13 (16.0) | |
| Macitentan | 81 (47.6) | 10 (12.3) | |
| None | 30 (17.6) | 36 (44.4) | |
| ERA + PDE-5i, n (%) | 110 (64.7) | 36 (44.4) | 0.002 |
| Supplemental oxygen use, n (%) | 74 (44.0) | 37 (47.4) | 0.68 |
| Abbreviations: CI, cardiac index; ERA, endothelin receptor antagonist; mPAP, mean pulmonary artery pressure; PAH, pulmonary arterial hypertension; PCWP, pulmonary capillary wedge pressure; PDE-5i, phosphodiesterase-5 inhibitor; PVR, pulmonary vascular resistance; Q1, quartile 1; Q2, quartile 2; RHC, right heart catheterization; WHO, World Health Organization. | |||
Results
Two hundred fifty-one patients were included in the analysis with 170 patients in the UPTRAVI group and 81 patients in the inhaled treprostinil group. The primary endpoint occurred in 21.7% (37/170) and 20.9% (17/81) of patients in the UPTRAVI and inhaled treprostinil groups, respectively, and was adjusted for age, gender, World Health Organization Functional Class (WHO FC), and background dual therapy (HR, 1.05; 95% CI, 0.57-1.86; P=0.86). The incidence rate was 18.25 and 21 events per 100 patient-years in the UPTRAVI and inhaled treprostinil group, respectively (P=0.64 by log-rank test).1
Drug discontinuation due to side effects occurred in 8.8% (15/170) and 23.5% (19/81) of patients in the UPTRAVI and inhaled treprostinil groups, respectively (adjusted OR, 3.2; 95% CI, 1.51-6.62; P=0.002).1
Literature Search
A literature search of MEDLINE®
References
| 1 | Nguyen J, Teklu Y, Wu S, et al. Oral selexipag versus inhaled treprostinil effect on pulmonary arterial hypertension [abstract]. J Heart Lung Transplant. 2022;41(4):S427. |