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ABSTRACT: Background
Pulmonary arterial hypertension (PAH) is a rare, progressive disease. The treatment landscape for PAH in Japan has evolved considerably in recent years, but there is limited knowledge of the changes in treatment practices or patient characteristics.Objectives
The aim of this study was to evaluate the changes in characteristics and initial treatments for PAH in Japan over time.Methods
This study used data from the Japan Pulmonary Hypertension Registry (JAPHR) to compare patient characteristics and treatment practices between 2008-2015 (n = 316) and 2016-2020 (n = 315).Results
The mean ± standard deviation age at diagnosis increased from 47.9 ± 16.7 years in 2008-2015 to 52.7 ± 16.9 years in 2016-2020. The mean pulmonary arterial pressure decreased from 45.4 ± 15.0 to 38.6 ± 13.1 mm Hg. Idiopathic/hereditary PAH was the most common etiology in both periods (50.0% and 51.1%, respectively). The proportion of patients prescribed oral/inhaled combination therapies increased from 47.8% to 57.5%. Oral/inhaled combination therapies were frequently prescribed to patients with congenital heart disease-related PAH (81.8%). There was no significant trend in prescribing practices based on French low-risk criteria: among patients with 0, 1, 2, 3, or 4 criteria, 53.8%, 68.8%, 52.8%, 66.7%, and 39.4% were prescribed oral/inhaled combination therapies, and 0%, 16.7%, 27.0%, 17.3%, and 15.2% were prescribed oral/inhaled monotherapies. Macitentan, tadalafil, selexipag, and epoprostenol were the most frequently prescribed drugs.Conclusions
The severity of PAH decreased over time in Japan. Oral/inhaled combination therapies were generally preferred. Physicians generally prescribed therapies after considering the patients' hemodynamics and clinical severity. (Japan Pulmonary Hypertension Registry [JAPHR]; UMIN000026680).
SUBMITTER: Tamura Y
PROVIDER: S-EPMC9627817 | biostudies-literature | 2022 Jun
REPOSITORIES: biostudies-literature
Tamura Yuichi Y Kumamaru Hiraku H Inami Takumi T Matsubara Hiromi H Hirata Ken-Ichi KI Tsujino Ichizo I Suda Rika R Miyata Hiroaki H Nishimura Shiori S Sigel Byron B Takano Masashi M Tatsumi Koichiro K
JACC. Asia 20220517 3
<h4>Background</h4>Pulmonary arterial hypertension (PAH) is a rare, progressive disease. The treatment landscape for PAH in Japan has evolved considerably in recent years, but there is limited knowledge of the changes in treatment practices or patient characteristics.<h4>Objectives</h4>The aim of this study was to evaluate the changes in characteristics and initial treatments for PAH in Japan over time.<h4>Methods</h4>This study used data from the Japan Pulmonary Hypertension Registry (JAPHR) to ...[more]