The MELODY-1 study evaluated macitentan for pulmonary hypertension because of left heart disease (PH-LHD) in patients with combined post- and pre-capillary PH.63 patients with PH-LHD and diastolic pressure gradient ≥7 mmHg and pulmonary vascular resistance (PVR) >3WU were randomised to macitentan 10 mg (n=31) or placebo (n=32) for 12 weeks. The main end-point assessed a composite of significant fluid retention (weight gain ≥5% or ≥5 kg because of fluid overload or parenteral diuretic administration) or worsening in New York Heart Association functional class from baseline to end of treatment. Exploratory end-points included changes in N-terminal pro-brain natriuretic peptide (NT-proBNP) and haemodynamics at week 12.Seven macitentan-treated and four placebo-treated patients experienced significant fluid retention/worsening functional class; treatment difference, 10.08% (95% CI -15.07-33.26; p=0.34). The difference, driven by the fluid retention component, was apparent within the first month. At week 12, versus placebo, the macitentan group showed no change in PVR, mean right atrial pressure or pulmonary arterial wedge pressure; a non-significant increase in cardiac index (treatment effect 0.4 (95% CI 0.1-0.7) L·min-1·m-2) and decrease in NT-proBNP (0.77 (0.55-1.08)) was observed. Adverse events and serious adverse events were numerically more frequent with macitentan versus placebo.Macitentan-treated patients were quantitatively more likely to experience significant fluid retention versus placebo. Macitentan resulted in no significant changes in any exploratory end-points.
- MeSH
- cévní rezistence účinky léků MeSH
- dvojitá slepá metoda MeSH
- dysfunkce levé srdeční komory komplikace MeSH
- internacionalita MeSH
- krevní tlak účinky léků MeSH
- lidé MeSH
- natriuretický peptid typu B účinky léků metabolismus MeSH
- peptidové fragmenty účinky léků metabolismus MeSH
- plicní hypertenze farmakoterapie patofyziologie MeSH
- plicní tlak v zaklínění účinky léků MeSH
- pyrimidiny aplikace a dávkování MeSH
- senioři MeSH
- sulfonamidy aplikace a dávkování MeSH
- test chůzí MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- Názvy látek
- macitentan MeSH Prohlížeč
- natriuretický peptid typu B MeSH
- peptidové fragmenty MeSH
- pro-brain natriuretic peptide (1-76) MeSH Prohlížeč
- pyrimidiny MeSH
- sulfonamidy MeSH