Real-world experience of elderly patients with pulmonary arterial hypertension (PAH) initiating selexipag (EXPOSURE/EXTRACT studies)

Real-world evidence is needed for better management of PAH in the growing elderly population, as clinical trials often exclude these patients. This analysis describes characteristics, treatment patterns and outcomes of PAH patients initiating selexipag in patients over 75 years old and the overall population. Pooled data from prospective EXPOSURE (EUPAS19085) and retrospective EXTRACT (EUPAS49227) observational PAH studies, in Europe and Canada, were used. As of 2023, 117/976 (12%) patients who initiated selexipag with follow up information were over 75 years old. Their characteristics are described in the Table. Selexipag was initiated as triple oral combination therapy in the vast majority (85%). During the median (Q1, Q3) exposure period of 7.9 (2.9, 22.6) months, 68 (58%) patients discontinued selexipag, including 29 (25%) due to tolerability/adverse event (AE); 29 patients died. One-year Kaplan-Meier (KM) survival estimate was 79%. In the overall population, the median (Q1, Q3) exposure period was longer (13.0 [4.1, 29.0] months), fewer patients discontinued selexipag (41%), including 167 (17%) due to tolerability/AE, and one-year KM survival estimate was higher (92%); 116 patients died. These data suggest selexipag is predominately initiated as triple combination therapy in elderly patients, with consideration needed for managing side effects to improve tolerability. <fig><object-id>erj;64/suppl_68/PA4317/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>