Pulmonary arterial hypertension combo therapy
Combo Therapy May Increase Long-term Survival in PAH
(AMBITION trial Post-hoc analysis)
In patients with PAH (Pulmonary Arterial Hypertension), combination therapy of ambrisentan and tadalafil at 7 days after the end of randomized treatment showed a significant reduction in mortality in comparison to ambrisentan or tadalafil alone.
In patients who have not been treated before, time to first clinical failure with combination therapy was longer (largely due to a reduction in hospital admissions). At the end of the study, 10% of patients in the combination therapy group had died compared with 14% in the monotherapy group.
At 7 days after the end of randomized treatment, fewer patients had died in the combination therapy group (1%) compared with the monotherapy group (4%).
The AMBITION trial was neither designed nor powered to detect a survival benefit for combined therapy but it is possible that despite these limitations, the findings from the post-hoc analysis “strongly raise the possibility that upfront combination therapy might improve death rate in this disease.