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Exploratory Post Hoc Analysis: Time‍-‍From‍-‍Diagnosis Subgroups

Treat Early With UPTRAVI®1

Baseline patient characteristics2*

Treated ≤6 months from diagnosis

35% (n=404/1156; 52% FC II and 46% FC III)

Background therapy

  • 41%
    PDE5i
    (n=165/404)
  • 39%
    None
    (n=157/404)
  • 10%
    ERA
    (n=42/404)
  • 10%
    ERA + PDE5i
    (n=40/404)
Time to first disease progression event in patients treated after 6 months of PAH diagnosis (UPTRAVI® vs placebo)2

Summary of primary endpoint events in patients treated within 6 months of PAH diagnosis2

UPTRAVI® n=207
% (n)
Placebo n=197
% (n)
PRIMARY COMPOSITE ENDPOINT:
Morbidity/mortality up to end of treatment period||
All primary endpoint events27.5% (57)50.3% (99)
Hospitalization for PAH11.6% (24)19.8% (39)
Other disease progression
(decrease in 6MWD plus worsening FC or need for other therapy)
7.2% (15)24.4% (48)
Death6.8% (14)5.1% (10)
Parenteral prostanoid or chronic oxygen therapy1.9% (4)1.0% (2)
Need for lung transplantation or balloon atrial septostomy for worsening of PAH0% (0)0% (0)

The analysis described here is post hoc and exploratory. The subgroup was not prespecified for evaluation of the primary endpoint. Please note this analysis did not compare patients treated within 6 months of PAH diagnosis with patients treated after 6 months of PAH diagnosis. Sample size should be considered and results should be interpreted with caution.

Adverse reactions in ≤6 months from diagnosis subgroup occurring more frequently with UPTRAVI® compared with placebo by ≥3%2


ADVERSE REACTIONUPTRAVI® n=207
% (n)
Placebo
n=196
% (n)
Headache61% (126)27% (53)
Diarrhea32% (67)14% (28)
Nausea23% (48)10% (20)
Pain in jaw16% (34)4% (7)
Vomiting16% (32)7% (14)
Pain in extremity14% (29)2% (4)
Myalgia13% (27)7% (14)
Arthralgia13% (26)6% (11)
Nasopharyngitis10% (21)7% (13)
Flushing8% (17)4% (7)

Baseline patient characteristics2*

Treated >6 months from diagnosis

65% (n=752/1156; 42% FC II and 56% FC III)

Background therapy

  • 28%
    PDE5i
    (n=209/752)
  • 11%
    None
    (n=79/752)
  • 17%
    ERA
    (n=128/752)
  • 45%
    ERA + PDE5i
    (n=336/752)
Time to first disease progression event in patients treated after 6 months of PAH diagnosis (UPTRAVI® vs placebo)2

Summary of primary endpoint events in patients treated after 6 months of PAH diagnosis2

UPTRAVI® n=367
% (n)
Placebo n=385
% (n)
PRIMARY COMPOSITE ENDPOINT:
Morbidity/mortality up to end of treatment period||
All primary endpoint events26.7% (98)37.1% (143)
Hospitalization for PAH14.7% (54)18.2% (70)
Other disease progression
(decrease in 6MWD plus worsening FC or need for other therapy)
6.3% (23)13.5% (52)
Death3.8% (14)2.1% (8)
Parenteral prostanoid or chronic oxygen therapy1.6% (6)2.9% (11)
Need for lung transplantation or balloon atrial septostomy for worsening of PAH0.3% (1)0.5% (2)

The analysis described here is post hoc and exploratory. The subgroup was not prespecified for evaluation of the primary endpoint. Please note this analysis did not compare patients treated within 6 months of PAH diagnosis with patients treated after 6 months of PAH diagnosis. Sample size should be considered and results should be interpreted with caution.

Adverse reactions in >6 months from diagnosis subgroup occurring more frequently with UPTRAVI® compared with placebo by ≥3%2


ADVERSE REACTIONUPTRAVI® n=368
% (n)
Placebo
n=381
% (n)
Headache68% (249)36% (136)
Diarrhea48% (177)22% (82)
Nausea39% (145)23% (87)
Pain in jaw31% (114)8% (29)
Vomiting20% (72)9% (35)
Pain in extremity19% (68)11% (42)
Myalgia18% (65)5% (20)
Flushing14% (53)6% (22)

*Mean age for ≤6 months subgroup: UPTRAVI® (44 years), placebo (44 years). Mean age for >6 months subgroup: UPTRAVI® (50 years), placebo (50 years). FC II in ≤6 months subgroup: UPTRAVI® (55%), placebo (49%). FC II in >6 months subgroup: UPTRAVI® (44%), placebo (41%).

This threshold has previously been used to define newly diagnosed patients with PAH.

Adjusted for the following covariates: baseline PAH therapy, WHO FC, sex, race, age, etiology, geographical region, baseline 6MWD, and NT-proBNP. Not adjusted for multiplicity.

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

Treatment period defined as 7 days after last intake of UPTRAVI® or placebo.

6MWD=6-minute walk distance; CI=confidence interval; ERA=endothelin receptor antagonist; FC=Functional Class; GRIPHON=Prostacyclin (PGI2) Receptor Agonist In Pulmonary Arterial HypertensiON; HR=hazard ratio; NT-proBNP=N-terminal pro-brain natriuretic peptide; PDE5i=phosphodiesterase type-5 inhibitor; WHO=World Health Organization.

References: 1. UPTRAVI® (selexipag) full Prescribing Information. Actelion Pharmaceuticals US, Inc. 2. Gaine S, Sitbon O, Channick RN, et al. Relationship between time from diagnosis and morbidity/mortality in pulmonary arterial hypertension: results from the phase III GRIPHON study. Chest. 2021;160(1):277-286.