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Impact of treatment escalation on rehospitalization among patients with pulmonary arterial hypertension
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Impact of treatment escalation on rehospitalization among patients with pulmonary arterial hypertension
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Journal Article
Impact of treatment escalation on rehospitalization among patients with pulmonary arterial hypertension
2025
Overview
Pulmonary arterial hypertension (PAH) poses a substantial burden, including hospitalizations. This study assessed the impact of treatment escalation on rehospitalization. The Komodo Research Data (10/2015–03/2022) was used to identify adults with ≥ 1 PAH-related hospitalization (
index:
first hospitalization). Patients on monotherapy pre-index were assigned to the
Escalation-to-combination cohort
(treatment added ≤ 90 days post-index) or the
Monotherapy cohort
(no treatment change ≤ 90 days post-index). A sensitivity analysis was conducted among all patients who were treated pre-index. Entropy balancing was used to create cohorts with similar characteristics. All-cause hospitalizations per-patient-per-month (PPPM) during ≤ 12 months post-index were compared across balanced cohorts. A total of 203 and 1252 patients were included in the Escalation-to-combination and Monotherapy cohorts, respectively (mean age: 61 vs. 62 years; 67% vs. 68% female); most received PDE5i monotherapy pre-index (65.3% vs. 75.9%). Post-index, 84.5% of the Escalation-to-combination cohort increased to dual therapy, most commonly PDE5i + ERA (39.4%) and PDE5i + PPA (24.7%). Rehospitalization was lower in the Escalation-to-combination than Monotherapy cohort (incidence rate ratio [95% confidence interval]: 0.69 [0.55–0.90]; p < 0.001); the sensitivity analysis yielded similar results. Treatment escalation was associated with a lower rehospitalization rate, suggesting that earlier escalation and broader use of combination therapy may reduce PAH burden.
Publisher
Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
Subject
/ Aged
/ Antihypertensive Agents - therapeutic use
/ Female
/ Humanities and Social Sciences
/ Humans
/ Male
/ Patient Readmission - statistics & numerical data
/ Phosphodiesterase 5 Inhibitors - therapeutic use
/ Pulmonary arterial hypertension (PAH)
/ Pulmonary Arterial Hypertension - drug therapy
/ Science
