Assessment of Group 1 PAH patients on triple therapy clinical four risk strata outcome in a UAE centre

<bold>Aim:</bold> To assess clinical four risk criteria outcome Group I PAH (G1) on triple therapy at a UAE tertiary referral centre.¹ <bold>Method:</bold> Retrospective study on adults, right heart catheterization confirmed G1 between January 2015-June 2023 advanced to best available triple therapy. <bold>Results:</bold> 54 consecutive patients were diagnosed as G1 over the study period.20 patients (37%)were classified as idiopathic, 20(37%) connective tissue disease(CTD), 14(26%) congenital heart disease(CHD). Median follow-up was 35.5 (9-82) months. All patients escalated to triple combination therapy by Prostacyclin analogues (Treprostinil IV/SQ, selexipag/iloprost inhaled) as third agent for atleast 3 months as best available therapy.1-,3-,5-year cumulative survival probability for Idiopathic was 95%(95%CI,75-92%),CTD 83%(95%CI,54-80%),CHD100%(95 CI,54-80%). In last follow-up visit, 48%patients were in low and intermediate-low risk,30% and 22% in intermediate-high and high-risk strata respectively. 8% of intermediate-high and high-risk strata patients were treated with selexipag/inhaled iloprost not IV/Sq prostacyclin due to lacking insurance coverage. 37% treated with iv/Sq prostacyclin remain in intermediate-high and high-risk patients equally distributed between the CTD and idiopathic G1. <bold>Conclusion:</bold> Many patients remain in intermediate-high and high-risk category despite optimal triple therapy. Novel therapy pathway is needed for optimal clinical target. <fig><object-id>erj;64/suppl_68/PA4318/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>