Condition

Pulmonary Arterial Hypertension

Clinical trials and treatment information for Pulmonary Arterial Hypertension

192K

People Affected

Active Trials

2,877

New Cases/Year

22K

Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

Treprostinil (Parenteral/Inhaled)

90% Effectiveness• 95% Confidence• 30% Safety• 1 trials• 8K participants

HIGH EvidencePoor ValueDose: Highly variable, titrated individually (e.g., IV/SC 1.25 ng/kg/min; inhaled 3-9 breaths 4 times daily)

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-2 months (titration)

Duration

Lifetime

Response Rate

50%

Remission Rate

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Headache: 70%

Jaw Pain: 50%

Flushing: 40%

Nausea/Diarrhea: 30%

Injection site pain/infection (parenteral): 85%

Cough (inhaled): 35%

Annual Cost of Care

Drug Cost

$180,000

Monitoring

$10,000

Side Effects

$12,000

Total Annual

$202,000

Cost-Effectiveness

POOR

QALYs Gained

ICER

$400,000/QALY

Cost per Remission

$2,885,714

Cost per Responder

$404,000

Treatment Outcomes

Primary Outcomes

6-Minute Walk Distance320 meters

+8.75% (+28 meters)

Pulmonary Vascular Resistance10 Wood units

-40% (-4.0 Wood units)

N-terminal pro-brain natriuretic peptide (NT-proBNP)1500 pg/mL

-33.33% (-500 pg/mL)

Mean Pulmonary Artery Pressure (mPAP)55 mmHg

-9.09% (-5 mmHg)

Secondary Benefits

Borg Dyspnea Index at Peak Exercise6/10

-25% (-1.5 points)

CAMPHOR Activity Score20/30

-20% (-4 points)

Cardiac Index2.0 L/min/m^2

+15% (+0.3 L/min/m^2)

Common Side Effects

Headache

+70%

Jaw Pain

+50%

Flushing

+40%

Clinical Trial Phases:

Phase 3Phase 4

Macitentan

85% Effectiveness• 90% Confidence• 58% Safety• 20 trials• 6K participants

HIGH EvidenceModerate ValueDose: 10mg once daily

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

3-6 months

Duration

Lifetime

Response Rate

38%

Remission Rate

Number Needed to Treat (NNT)

Common Side Effects:

Anemia: 12%

Nasopharyngitis: 10%

Headache: 10%

Peripheral Edema: 8%

Annual Cost of Care

Drug Cost

$120,000

Monitoring

$5,000

Side Effects

$1,000

Total Annual

$126,000

Cost-Effectiveness

MODERATE

QALYs Gained

0.4

ICER

$180,000/QALY

Cost per Remission

$2,100,000

Cost per Responder

$331,579

Treatment Outcomes

Efficacy Outcomes

Overall Effectiveness

+85%

Response Rate

+38%

Remission Rate

+6%

Common Side Effects

Anemia

+12%

Nasopharyngitis

+10%

Headache

+10%

Clinical Trial Phases:

Phase 3Phase 4

Riociguat

82% Effectiveness• 90% Confidence• 35% Safety• 47 trials• 2.5K participants

HIGH EvidenceModerate ValueDose: 0.5mg three times daily, titrated up to 2.5mg three times daily

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-3 months

Duration

Lifetime

Response Rate

35%

Remission Rate

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Headache: 25%

Dyspepsia: 12%

Dizziness: 10%

Nausea: 10%

Hypotension: 7%

Annual Cost of Care

Drug Cost

$120,000

Monitoring

$5,000

Side Effects

$1,000

Total Annual

$126,000

Cost-Effectiveness

MODERATE

QALYs Gained

0.3

ICER

$160,000/QALY

Cost per Remission

$2,520,000

Cost per Responder

$360,000

Treatment Outcomes

Primary Outcomes

6-minute walk distance370 meters

+9.5% (+35 meters)

Pulmonary Vascular Resistance900 dyn·s·cm⁻⁵

-25% (-225 dyn·s·cm⁻⁵)

N-terminal pro-B-type natriuretic peptide1500 pg/mL

-35% (-525 pg/mL)

Secondary Benefits

Cardiac Index2.2 L/min/m²

+13.6% (+0.3 L/min/m²)

Mean Pulmonary Artery Pressure52 mmHg

-13.5% (-7 mmHg)

Borg Dyspnea Scale (peak 6MWD)3.5 points (0-10 scale)

-23% (-0.8 points)

Common Side Effects

Headache

+25%

Dyspepsia

+12%

Dizziness

+10%

Clinical Trial Phases:

Phase 3Phase 4

Sildenafil

80% Effectiveness• 95% Confidence• 60% Safety• 125 trials• 12K participants

HIGH EvidenceExcellent ValueDose: 20mg three times daily

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Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

Weeks to months

Duration

Lifetime

Response Rate

40%

Remission Rate

Number Needed to Treat (NNT)

Common Side Effects:

Headache: 50%

Flushing: 25%

Dyspepsia: 18%

Nasal Congestion: 12%

Visual Disturbances: 10%

Annual Cost of Care

Drug Cost

$2,000

Monitoring

$4,500

Side Effects

$300

Total Annual

$6,800

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.2

Cost per Remission

$85,000

Cost per Responder

$17,000

Treatment Outcomes

Primary Outcomes

6-Minute Walk Distance330 meters

+12.12% (+40 meters)

Pulmonary Vascular Resistance1000 dyn·s·cm⁻⁵

-25% (-250 dyn·s·cm⁻⁵)

Mean Pulmonary Artery Pressure55 mmHg

-14.5% (-8 mmHg)

Secondary Benefits

N-terminal pro-BNP (NT-proBNP)1500 pg/mL

-25% (-375 pg/mL)

Cardiac Index2.0 L/min/m²

+15% (+0.3 L/min/m²)

Borg Dyspnea Scale Score5/10

-30% (-1.5 points)

Common Side Effects

Headache

+50%

Flushing

+25%

Dyspepsia

+18%

Clinical Trial Phases:

Phase 3Phase 4

Tadalafil

78% Effectiveness• 95% Confidence• 60% Safety• 44 trials• 9K participants

HIGH EvidenceExcellent ValueDose: 40mg once daily

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

Weeks to months

Duration

Lifetime

Response Rate

35%

Remission Rate

Number Needed to Treat (NNT)

Common Side Effects:

Headache: 30%

Flushing: 15%

Dyspepsia: 12%

Nasal Congestion: 8%

Back Pain: 8%

Annual Cost of Care

Drug Cost

$2,500

Monitoring

$4,500

Side Effects

$300

Total Annual

$7,300

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.2

Cost per Remission

$104,286

Cost per Responder

$20,857

Treatment Outcomes

Primary Outcomes

6-Minute Walk Distance320 meters

+10% (+33 meters)

Pulmonary Vascular Resistance10 Wood units

-25% (-2.5 Wood units)

Mean Pulmonary Artery Pressure55 mmHg

-7% (-4 mmHg)

WHO Functional Class Score2.8 points (on 1-4 scale, 1=best)

-18% (-0.5 points)

Secondary Benefits

NT-proBNP1500 pg/mL

-25% (-375 pg/mL)

SF-36 Physical Component Summary Score35 points (on 0-100 scale)

+11% (+4 points)

Tricuspid Annular Plane Systolic Excursion (TAPSE)15 mm

+17% (+2.5 mm)

Common Side Effects

Headache

+30%

Flushing

+15%

Dyspepsia

+12%

Clinical Trial Phases:

Phase 3Phase 4

Bosentan

75% Effectiveness• 90% Confidence• 55% Safety• 73 trials• 7K participants

HIGH EvidenceGood ValueDose: 62.5mg twice daily for 4 weeks, then 125mg twice daily

Find Trials

Comparative Safety Scale(Higher is safer)

Cyanide☠️

Meth💀

Cigarettes🚬

Chemo☢️

Alcohol🍺

Morphine💊

Antibiotics💉

Tylenol💊

Exercise🏃

Water💧

DangerousModerateSafe

Time to Effect

1-3 months

Duration

Lifetime

Response Rate

32%

Remission Rate

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Headache: 18%

Flushing: 8%

Peripheral Edema: 12%

Anemia: 12%

Liver enzyme elevation: 10%

Annual Cost of Care

Drug Cost

$10,000

Monitoring

$6,000

Side Effects

$800

Total Annual

$16,800

Cost-Effectiveness

GOOD

QALYs Gained

0.25

ICER

$85,000/QALY

Cost per Remission

$336,000

Cost per Responder

$52,500

Treatment Outcomes

Primary Outcomes

6-Minute Walk Distance340 meters

+10% (+34 meters)

Pulmonary Vascular Resistance850 dyn·s·cm⁻⁵

-20% (-170 dyn·s·cm⁻⁵)

Mean Pulmonary Arterial Pressure55 mmHg

-10% (-5.5 mmHg)

Cardiac Index2.1 L/min/m²

+12% (+0.25 L/min/m²)

Secondary Benefits

NT-proBNP1500 pg/mL

-30% (-450 pg/mL)

SF-36 Physical Component Summary (PCS)SF-36 PCS score: 38 points

+10% (+3.8 points)

Common Side Effects

Headache

+18%

Flushing

+8%

Peripheral Edema

+12%

Clinical Trial Phases:

Phase 3Phase 4