Combination therapy in pulmonary arterial hypertension (PAH): the evidence grows

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Chairs: A. Vonk Noordegraaf (Amsterdam, The Netherlands), G. Simonneau (Le Kremlin-Bicêtre, France)
Aims: Over the past 20 years multiple agents targeting different pathways have been licensed for the treatment of Pulmonary Arterial Hypertension (PAH). Due to the severity and progressive nature of the disease, combination therapy with agents targeting these different pathways has become increasingly utilised over the years. Currently sequential addition, based on a treat to goal strategy, is recommended by the ERS/ESC treatment guidelines. Despite this progress, PAH survival rates remain unacceptably low. There is therefore increasing interest in an upfront combination therapy strategy to improve long-term outcomes, though data up to now is limited.

Evidence of efficacy for sequential combination therapy in recent randomized controlled trials (RCTs) J.L. Vachiéry (Brussels, Belgium)
Upfront combination PAH therapy in severe PAH O. Sitbon (Le Kremlin-Bicêtre, France)
The AMBITION study: design and results N. Galiè (Bologna, Italy)