Long-Term Safety, Tolerability and Efficacy of Macitentan in Patients with Inoperable Chronic Thromboembolic Pulmonary Hypertension: The MERIT-1 Study and Its Open-Label Extension MERIT-2

Howard, Luke; Ghofrani, HA; D’Armini, Andrea Maria; Fedullo, Peter F.; Gesang, S.; Jaïs, Xavier; Jenkins, David P.; Jing, Zhi; Madani, Michael M.; Mitchell, L.; Mayer, Eckhard; Papadakis, Kelly; Kim, N.H.; Simonneau, Gérald

doi:10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a6068

Cited by 4 publications

(4 citation statements)

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“…3,7 Several other PAH-approved agents have been evaluated in patients with CTEPH, most notably macitentan, which showed benefits on PVR in patients with inoperable CTEPH in the MERIT-1 (Macitentan for the Treatment of Inoperable Chronic Thromboembolic Pulmonary Hypertension) study and in preliminary results from its long-term extension, MERIT-2. 33,34 In selected patients with CTEPH, BPA can improve hemodynamics, symptoms, exercise capacity, and RV function. 7…”

Section: Treatment Of Phmentioning

confidence: 99%

Pulmonary Hypertension: A Brief Guide for Clinicians

Mandras

Mehta

Vaidya

2020

Mayo Clinic Proceedings

190

123

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Section: Treatment Of Phmentioning

confidence: 99%

Pulmonary Hypertension: A Brief Guide for Clinicians

Mandras

Mehta

Vaidya

2020

Mayo Clinic Proceedings

190

123

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“…Larger randomized controlled studies over a longer duration are required to validate the use of combination therapy in CTEPH. Improvements observed with macitentan in MERIT-1 were maintained at up to 6 months of the long-term extension MERIT-2 [73].…”

Section: Merit-1mentioning

confidence: 77%

Interventional and pharmacological management of chronic thromboembolic pulmonary hypertension

Ghofrani

D’Armini

Kim

et al. 2021

Respiratory Medicine

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Chronic thromboembolic pulmonary hypertension (CTEPH) is caused by obstruction of the pulmonary vasculature, leading to increased pulmonary vascular resistance and ultimately right ventricular failure, the leading cause of death in non-operated patients. This article reviews the current management of CTEPH. The standard of care in CTEPH is pulmonary endarterectomy (PEA). However, up to 40% of patients with CTEPH are ineligible for PEA, and up to 51% develop persistent/recurrent PH after PEA. Riociguat is currently the only medical therapy licensed for treatment of inoperable or persistent/recurrent CTEPH after PEA based on the results of the Phase III CHEST-1 study. Studies of balloon pulmonary angioplasty (BPA) have shown benefits in patients with inoperable or persistent/recurrent CTEPH after PEA; however, data are lacking from large, prospective, controlled studies. Studies of macitentan in patients with inoperable CTEPH and treprostinil in patients with inoperable or persistent/recurrent CTEPH showed positive results. Combination therapy is under evaluation in CTEPH, and long-term data are not available. In the future, CTEPH may be managed by PEA, medical therapy or BPAalone or in combination, according to individual patient needs. Patients should be referred to experienced centers capable of assessing and delivering all options.

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“…New data in support of medical therapy for inoperable patients were provided in the MERIT-2 trial. 43 The MERIT-1 trial was a 24-week MCRDBPCT that demonstrated the benefit of macitentan in a cohort of 80 patients with CTEPH ineligible for surgery. 44 MERIT-2 assessed the long-term safety, tolerability, and efficacy of macitentan in 76 of the original 80 patients.…”

Section: Special Populations and Topicsmentioning

confidence: 99%

“…Overall, those patients originally in the macitentan arm of MERIT-1 did better. 43 An emerging option for inoperable or residual CTEPH is balloon pulmonary angioplasty (BPA). 45,46 The RACE trial compared BPA with riociguat, demonstrating a larger improvement in PVR at 26 weeks with BPA (geometric mean reduction: 60% in BPA arm, 32% in riociguat arm; P<.0001) but with more adverse effects (serious adverse events: 50% in BPA arm, 26% in riociguat arm).…”

Section: Special Populations and Topicsmentioning

confidence: 99%

Topic-Based, Recent Literature Review on Pulmonary Hypertension

Burger

DuBrock

Cartin‐Ceba

et al. 2021

Mayo Clinic Proceedings

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Pulmonary hypertension is a complex condition but a relatively common manifestation of severe cardiopulmonary disease. By contrast, pulmonary arterial hypertension is uncommon and is more prevalent in young women. To better categorize patients and to guide clinical decision-making, 5 diagnostic groups and associated subgroups characterize the spectrum of disease. A multidisciplinary approach to evaluation and treatment is recommended by published guidelines and often entails referral to a designated pulmonary hypertension center. Several key publications during the last couple of years merit review. The PubMed database was searched for English-language studies and guidelines relating to pulmonary hypertension. The following terms were searched, alone and in combination: pulmonary hypertension, pulmonary arterial hypertension, portopulmonary hypertension, and chronic thromboembolic pulmonary hypertension. The focus was on those publications with new information on evaluation and management of pulmonary hypertension between January 1, 2019, and January 31, 2021. Of the subgroups, 2 were of particular interest for this review: portopulmonary hypertension and chronic thromboembolic pulmonary hypertension. Last, available data on the impact of the coronavirus disease 2019 pandemic and newer treatment agents in early trials were selectively reviewed. The review is therefore intended to serve as a practical, focused review of important topics germane to those clinicians caring for patients with pulmonary hypertension.pulmonary hypertension, pulmonary arterial hypertension, right ventricular failure

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Long-Term Safety, Tolerability and Efficacy of Macitentan in Patients with Inoperable Chronic Thromboembolic Pulmonary Hypertension: The MERIT-1 Study and Its Open-Label Extension MERIT-2

Cited by 4 publications

References 0 publications

Pulmonary Hypertension: A Brief Guide for Clinicians

Pulmonary Hypertension: A Brief Guide for Clinicians

Interventional and pharmacological management of chronic thromboembolic pulmonary hypertension

Topic-Based, Recent Literature Review on Pulmonary Hypertension

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