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2019-02

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cc-by-nc-nd (c) Elsevier, 2019
Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/183972

Initial combination therapy with ambrisentan + tadalafil on pulmonary arterial hypertension‒related hospitalization in the AMBITION trial

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https://doi.org/10.1016/j.healun.2018.11.006

Abstract

Background: In the randomized, double-blind, event-driven AMBITION study, initial combination therapy with ambrisentan and tadalafil was associated with a 50% reduction in risk of clinical failure (first occurrence of all-cause death, hospitalization for worsening pulmonary arterial hypertension [PAH], disease progression, or unsatisfactory long-term clinical response) vs pooled monotherapy. These results were primarily driven by a reduction in PAH-related hospitalization in the combination therapy group, although a significant effect was not observed in a post-hoc analysis of all-cause hospitalization. Methods: The effect of initial combination therapy with ambrisentan and tadalafil in AMBITION was further explored to study PAH-related hospitalization, which was not reported in the primary publication. Results: Initial combination therapy was associated with a 63% reduction in risk of PAH-related hospitalization when compared with pooled monotherapy (hazard ratio [HR] 0.372, 95% confidence interval [CI] 0.217 to 0.639, p = 0.0002). For every 9 patients treated with combination therapy vs monotherapy, 1 PAH-related hospitalization could be prevented over a 1-year period. Serious adverse events leading to hospitalization, not necessarily PAH-related, occurred in 87 of 253 (34%) and 89 of 247 (36%) of patients on combination therapy and pooled monotherapy, respectively (post-hoc summary). Conclusions: Initial combination therapy with ambrisentan and tadalafil was found to reduce the risk of PAH-related hospitalization by 63% compared with pooled monotherapy.

Subject

Hipertensió pulmonar, Vasodilatadors

Subject (English)

Pulmonary hypertension, Vasodilators

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Articles publicats en revistes (Medicina)

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VACHIÉRY, Jean-Luc, et al. Initial combination therapy with ambrisentan + tadalafil on pulmonary arterial hypertension‒related hospitalization in the AMBITION trial. Journal of Heart and Lung Transplantation. 2019. Vol. 38, num. 2, pags. 194-202. ISSN 1053-2498. [consulted: 15 of August of 2026]. Available at: https://hdl.handle.net/2445/183972

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