What is the efficacy of selexipag for the treatment of pulmonary arterial hypertension (PAH)?

Updated: Apr 25, 2018
  • Author: Kristin E Schwab, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Selexipag is the first prostacyclin agonist approved in the United States. It is available in tablet form. It selectively activates the prostacyclin receptor (ie, IP-receptor), one of five types of prostanoid receptors. Unlike prostacyclin analogs, selexipag is selective for the IP receptor over other prostanoid receptors (ie, EP1-4, DP, FP, TP). Activating the IP receptor induces vasodilation and inhibits proliferation of vascular smooth muscle cells. It was approved in December 2015 for adults with PAH to delay disease progression and reduce the risk of hospitalization. Approval of selexipag was based on the phase 3 GRIPHON study (n=1156). Results showed that selexipag decreased the risk of morbidity/mortality by 39% compared with placebo (P <.0001). Efficacy observed was consistent across the key subgroups (eg, age, sex, WHO functional class, PAH etiology, and background PAH therapy). [48, 49, 50] Adverse effects are similar to the other prostacyclins and include headache, diarrhea, nausea, flushing, muscle aches, and jaw pain. Although these are mostly mild, they are reported in the majority of patients.


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