Real-world experience of selexipag titration in pulmonary arterial hypertension

Selexipag is an oral selective prostacyclin receptor agonist, that was approved for use in patients with NYHA functional class II-III pulmonary arterial hypertension (PAH). In the GRIPHON study, selexipag demonstrated consistent efficacy for individualised doses in low, medium and high dose stratums. In order to better understand the real world approach to selexipag titration and to establish the individualised maintenance regimens used in our centre, we performed this retrospective study of the first 20 patients prescribed selexipag. Baseline characteristics differed from the GRIPHON study, with more combination therapy and comorbidities at baseline; however. Maintenance doses were stratified as low-dose in 10% (n=2), medium-dose in 70% (n=14) and high-dose in 20% (n=4). Furthermore, two of these patients were successfully transitioned from inhaled iloprost. This study demonstrates that selexipag can be safely initiated, titrated and transitioned in an outpatient setting to achieve an individualised dosing regimen.