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Exploratory POST HOC ANALYSIS: CTD SUBGROUP

GRIPHON had the Largest CTD Population in a Randomized PAH Trial1,2

Baseline patient characteristics1*

Patients with PAH-CTD in GRIPHON

29% (n=334/1156)

Subtypes

  • 51%
    PAH-SSc
    (n=170/334)
  • 24.5%
    PAH-SLE
    (n=82/334)
  • 24.5%
    PAH-MCTD/CTD-Other
    (n=82/334)
  • FC II

    46%
    (n=154/334)
  • FC III

    53%
    PAH-SLE
    (n=176/334)
  • FC I OR IV

    1%
    (n=4/334)

Background therapy

  • 28%
    PDE5i
    (n=82/334)
  • 23%
    None
    (n=78/334)
  • 20%
    ERA
    (n=66/334)
  • 29%
    ERA + PDE5i
    (n=96/334)
Time to first disease progression event in patients with PAH-‍CTD (UPTRAVI® vs placebo)1
Patients without an event in the triple combination subgroup desktop curve

Summary of primary endpoint events in patients with PAH-‍CTD1

UPTRAVI® n=77
% (n)
Placebo n=197
% (n)
PRIMARY COMPOSITE ENDPOINT:
Morbidity/mortality up to end of treatment period||
All primary endpoint events28.7% (48)43.7% (73)
Hospitalization for PAH12.6% (21)21.6% (36)
Other disease progression
(decrease in 6MWD plus worsening
FC or need for other therapy)
6.6% (11)17.4% (29)
Death7.2% (12)1.8% (3)
Parenteral prostanoid or chronic oxygen therapy1.8% (3)3.0% (5)
Need for lung transplantation or balloon
atrial septostomy for worsening of PAH
0.6% (1)0% (0)

PAH-CTD was a prespecified subgroup for evaluation of the primary endpoint; however, the more detailed analyses described here are post hoc. Sample size should be considered and results should be interpreted with caution.

Adverse reactions in the PAH-CTD subpopulation occurring more frequently with UPTRAVI® compared with placebo by ≥3%1


ADVERSE REACTIONUPTRAVI® n=167
% (n)
Placebo
n=165
% (n)
Headache62% (104)36% (60)
Diarrhea40% (67)26% (42)
Nausea37% (62)25% (41)
Dizziness21% (35)18% (30)
Vomiting20% (34)6% (10)
Pain in extremity19% (31)5% (8)
Pain in jaw14% (24)7% (11)
Myalgia13% (21)6% (10)
Arthalgia11% (19)7% (12)
Nasopharyngitis11% (19)7% (12)
Flushing11% (19)5% (8)
Decreased appetite10% (17)6% (9)

Baseline patient characteristics1*

Of the 334 patients with PAH-CTD in GRIPHON,
Patients with PAH-SSc

51% (n=170/334)

  • FC II

    34%
    (n=57/170)
  • FC III

    65%
    PAH-SLE
    (n=110/170)
  • FC I OR IV

    2%
    (n=3/170)

Background therapy

  • 23%
    PDE5i
    (n=39/170)
  • 22%
    None
    (n=38/170)
  • 18%
    ERA
    (n=31/170)
  • 37%
    ERA + PDE5i
    (n=62/170)
Time to first disease progression event in patients with PAH-‍SSc (UPTRAVI® vs placebo)1
Patients without an event in the triple combination subgroup desktop curve

Summary of primary endpoint events in patients with PAH-‍SSc1

UPTRAVI® n=179
% (n)
Placebo n=197
% (n)
PRIMARY COMPOSITE ENDPOINT:
Morbidity/mortality up to end of treatment period||
All primary endpoint events32.5% (25)49.5% (46)
Hospitalization for PAH13.0% (10)23.7% (22)
Other disease progression
(decrease in 6MWD plus worsening
FC or need for other therapy)
10.4% (8)19.4% (18)
Death5.2% (4)1.1% (1)
Parenteral prostanoid or chronic oxygen therapy2.6% (2)5.4% (5)
Need for lung transplantation or balloon
atrial septostomy for worsening of PAH
1.3% (1)0% (0)

This subgroup analysis was post hoc and exploratory in nature. Sample size should be considered and results should be interpreted with caution.

Adverse reactions in the PAH-‍SSc subpopulation occurring more frequently with UPTRAVI® compared with placebo by ≥3%1


ADVERSE REACTIONUPTRAVI® n=77
% (n)
Placebo
n=91
% (n)
Headache55% (42)34% (31)
Diarrhea46% (35)28% (25)
Nausea31% (24)26% (24)
Dizziness22% (17)18% (16)
Pain in extremity22% (17)4% (4)
Pain in jaw20% (15)8% (7)
Back pain14% (11)7% (6)
Myalgia12% (9)8% (7)
Urinary tract infection10% (8)7% (6)
Asthenia10% (8)4% (4)

*Time from diagnosis (mean): UPTRAVI® (1.6 years for PAH-CTD subgroup; 1.5 years for PAH-SSc subpopulation), placebo (1.7 years for PAH-CTD subgroup; 1.6 years for PAH-SSc subpopulation). Average age: UPTRAVI® (52 years for PAH-CTD subgroup; 59 years for PAH-SSc subpopulation), placebo (53 years for PAH-CTD subgroup; 61 years for PAH-SSc subpopulation).

Due to smaller patient numbers and corresponding number of primary endpoint events, PAH-MCTD and PAH-CTD-Other patients were presented as a single group.

Not adjusted for multiplicity.

§Hazard ratio based on primary endpoint events up to the end of treatment.

Among the patients randomly assigned to the placebo group, 2 did not receive study treatment and were not included in the safety analysis set.

6MWD=6-minute walk distance; CI=confidence interval; CTD=connective tissue disease; ERA=endothelin receptor antagonist; FC=Functional Class; GRIPHON=Prostacyclin (PGI2) Receptor Agonist In Pulmonary Arterial HypertensiON; HR=hazard ratio; PAH-CTD=PAH associated with connective tissue disease; PAH-MCTD/CTD-Other=PAH associated with mixed connective tissue disease and CTD-Other; PAH-SLE=PAH associated with systemic lupus erythematosus; PAH-SSc=PAH associated with systemic sclerosis; PDE5i=phosphodiesterase type-5 inhibitor.

References: 1. Gaine S, Chin K, Coghlan G, et al. Selexipag for the treatment of connective tissue disease-associated pulmonary arterial hypertension. Eur Respir J. 2017;50(2):1602493. doi:10.1183/13993003.02493-2016. 2. Data on file. Actelion Pharmaceuticals US, Inc. PAH‍-‍CTD Subgroup Population. June 2024.