Mental Disorders and Quality of Life in Patients With Pulmonary Arterial Hypertension Treated With Sotatercept

Jan Fuge, Karen M. Olsson, Kira Remmert, Britta Stapel, Jan C. Kamp, Da-Hee Park, Marius M. Hoeper, Lotta Winter, Kai G. Kahl

https://doi.org/10.1002/pul2.70324 

Abstract

Sotatercept has recently expanded treatment options for pulmonary arterial hypertension (PAH), but its mental health and quality-of-life impact is not well characterized. We assessed psychiatric diagnoses and patient-reported outcomes in PAH patients treated with sotatercept within the clinical trial program. PAH Patients previously assessed for psychiatric disorders and quality of life were re-evaluated after ≥ 6 months of sotatercept exposure. A senior psychiatrist performed a Structured Clinical Interview for DSM-5, and participants completed validated questionnaires assessing anxiety/depression (HADS), metacognitive beliefs (MCQ-30), quality of life (WHOQOL-BREF), and PAH-related symptoms/impacts (PAH-SYMPACT™), alongside items capturing patient experiences during therapy. Twenty patients (85% female; median age 46 years) were included. Hemodynamics, biomarkers, and 6-min walk distance improved. The prevalence of at least one current psychiatric disorder remained high and largely unchanged from baseline to follow-up (50% to 45%). Major depressive disorder remained stable (25%), whereas adjustment disorder newly occurred in 25% of patients. HADS and MCQ-30 scores did not change. WHOQOL-BREF global scores increased modestly, but the mental health domain declined substantially (69.6 ± 13.3 to 48.1 ± 15.5, p = 0.001). PAH-SYMPACT™ indicated low symptom burden at follow-up. Many patients reported increased optimism and plans to travel or return to work, while some expressed concerns about finances and social security. While sotatercept treatment led to clinical improvements in PAH patients, the prevalence of mental disorders remained high with an increased prevalence in adjustment disorder. These findings support routine mental health assessment and targeted psychosocial support when initiating life-changing PAH therapies.

Read the full research article