How effective is macitentan (Aoposu) in treating pulmonary arterial hypertension? Analysis of the latest clinical data

Macitentan (macitentan) is the core oral endothelin receptor antagonist (ERA) for the treatment of pulmonary arterial hypertension (PAH) and has shown significant efficacy in multiple clinical studies around the world. as ETA/ETB Dual receptor antagonist, macitentan works by blocking endothelin‑1 (ET‑ pan>1) has a contraction and proliferation effect on vascular smooth muscle, improves pulmonary circulation dynamics, and reduces pulmonary artery pressure and pulmonary vascular resistance (PVR). This not only alleviates hemodynamic abnormalities, but also plays a key role in improving right ventricular function and is an important component of long-term PAH management.

Abundant evidence supports the efficacy of macitentan in adults PAH patients. The classic SERAPHIN Phase III clinical trial showed that compared with placebo, daily 10 mg macitentan can significantly reduce the incidence of clinical deterioration events and improve survival time while reducing PAH Related risk of hospitalization. Indicators such as 6 minute walking distance (6MWD) and World Health Organization functional class (WHO‑FC) were also improved, indicating that patients’ exercise tolerance and quality of life were improved. These data establish the clinical status of macitentan as a first-line ERA treatment.

Real-world studies further validate the efficacy and safety of macitentan in daily clinical practice. A multi-center retrospective study in China showed that after starting treatment 3–7 months, the WHO functional class of most patients was improved or maintained stable, and the average 6MWD increased by approximately approximately 45 meters, NT‑proBNP levels dropped significantly, reflecting the relief of cardiac load. These clinical improvement trends are consistent with randomized controlled trial results and support the utility of macitentan in routine care.

In terms of safety, macitentan is generally well tolerated, but attention needs to be paid to potential side effects and changes in laboratory indicators. Large-scale research and development and follow-up meta evaluation show that among the ERA drugs, the more common safety events of macitentan include an increased risk of anemia, etc., which requires regular monitoring of blood and liver function. The latest research has also expanded the application population of macitentan, and 6MWD elevation and WHO‑FC were also observed in pediatric PAH patients. Improved, the efficacy is similar to that in adults, and the incidence of adverse events is relatively low, suggesting that macitentan can exert clinical value in a wider range of PAH patients.

Keyword tags:

Macitentan, pulmonary hypertension, efficacy, clinical data, 6min walking distance, safety, real-world study

Reference materials:https://pubmed.ncbi.nlm.nih.gov/39044676/