Association Between Initial Oral Therapy and Outcomes in XXXX .

@entity1 @entity7856 @entity1782 @entity1223 @entity120 @entity2631 @entity4770 @entity204 @entity785
OBJECTIVE: To compare time to clinical worsening (TTCW) based on initial oral therapy for @entity120 ( @entity120 ) in @entity1 with @entity785 ( @entity785 )-related @entity120 . METHODS: Using data from the Pulmonary Hypertension Assessment and Recognition of Outcomes in @entity2631 (PHAROS) registry (a multicenter prospective observational study enrolling @entity785 @entity1 with incident @entity120 ), we selected @entity1 with group 1 @entity120 (World Health Organization Clinical Classification system) who received initial therapy (for 6 months) with an endothelin receptor antagonist ( @entity1782 ), a @entity7856 ( @entity7856 ) inhibitor, or a combination of these 2 agents ( @entity1782 / @entity7856 inhibitor). The main outcome was TTCW, defined as the first occurrence of @entity204 , @entity120 -related hospitalization, lung transplantation, initiation of parenteral @entity4770 treatment, or worsening symptoms. RESULTS: Ninety-eight @entity1 (24 in the @entity1782 group, 59 in the @entity7856 inhibitor group, and 15 in the @entity1782 / @entity7856 inhibitor group) were included. No significant differences in the baseline characteristics of the @entity1 were observed. TTCW was significantly worse in @entity1 in the @entity1782 group compared with those in the @entity7856 inhibitor group or the @entity1782 / @entity7856 inhibitor group. Ten @entity1 (41.6%) in the @entity1782 group died during the 3-year observation period, compared with 4 @entity1 (6.8%) in the @entity7856 inhibitor group and 1 @entity1 (6.7%) in the @entity1782 / @entity7856 inhibitor group. Baseline factors that were independently associated with a shorter TTCW were initial treatment with an @entity1782 (hazard ratio [HR] 2.63 [P   =   0.009]), lower diffusing capacity for @entity1223 (HR 0.69 per 10% of predicted change [P   =   0.04]), and higher pulmonary vascular resistance (HR 1.10 per Wood unit change [P   =   0.007]). CONCLUSION: Compared with initial treatment with a @entity7856 inhibitor or combination therapy with an @entity1782 and a @entity7856 inhibitor, initial therapy with an @entity1782 in @entity1 with @entity785 -related @entity120 was associated with significantly worse TTCW, even after adjustment for commonly accepted prognostic factors. Further study into the optimal initial oral therapy for @entity1 with @entity785 -related @entity120 is needed.
