Real-World Comparison of Patients With PH-ILD Initiating Inhaled Treprostinil Versus Patients Who Remain Untreated

Steven J. Cassady, Gautam V. Ramani, Benjamin Wu, Kellie Morland, Charles D. Burger

https://doi.org/10.1002/pul2.70203 

Abstract

Pulmonary hypertension due to interstitial lung disease (PH-ILD) is associated with high morbidity and mortality. Real-world patients initiating inhaled treprostinil are not well-characterized. This retrospective cohort study aimed to evaluate healthcare resource utilization in patients with PH-ILD who initiated treatment with inhaled treprostinil vs patients who remained untreated. Adult patients diagnosed with PH-ILD were indexed on initiation of inhaled treprostinil and patients who remained untreated were indexed on first observed PH diagnosis (31 March 2021–30 September 2024). Patients were excluded if they were ever treated with any pulmonary arterial hypertension therapy. Inhaled treprostinil patients were matched to up to four untreated patients. All-cause per-patient per-month (PPPM) hospitalizations and ICU-related hospitalizations were the primary outcomes of interest. 294 patients treated with inhaled treprostinil and 736 untreated patients were identified. Mean all-cause PPPM hospitalizations remained unchanged in the pre-index vs post-index periods in the inhaled treprostinil cohort (0.11 vs 0.12; p = 0.42) but significantly increased in untreated patients (0.12 vs 0.23; p < 0.01). ICU utilization also remained unchanged in the pre-index vs post-index periods for the inhaled treprostinil cohort (0.06 vs 0.07; p = 0.11) compared to the untreated cohort (0.06 vs 0.13; p < 0.01). Untreated patients had significantly higher post-index PPPM hospitalizations (p < 0.01) and ICU utilization (p < 0.01) compared to inhaled treprostinil patients. Patients who initiated inhaled treprostinil had a 30% decreased risk of hospitalization compared to untreated patients (relative risk: 0.70; 95% CI: 0.59–0.83; p < 0.01). Among real-world patients with PH-ILD, treatment with inhaled treprostinil is associated with fewer all-cause hospitalizations and ICU-related hospitalizations compared to untreated patients with PH-ILD.

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