ERS recommends add-on sotatercept for PAH patients not at low risk

The edition in brief

The European Respiratory Society's updated PAH treatment guideline recommends add-on sotatercept for patients already on PAH drugs who are at intermediate-low, intermediate-high or high risk, based on high-certainty randomised evidence, with treatment in specialist centres; it suggests right heart catheterisation during follow-up in these groups when it would change treatment, and makes no recommendation for low-risk patients. In 19,324 patients in the EMBARC bronchiectasis registry, risk of future exacerbations rose with each prior exacerbation, from an incidence rate ratio of 1.45 after one to 3.56 after four or more, and one prior hospitalised exacerbation carried a 3.96-fold rate of future severe exacerbations. In 3,370 French patients with moderate-to-severe sleep apnoea, PAP use of at least 4 hours a night was associated with fewer major cardiovascular events (HR 0.53), more strongly in those with high hypoxic burden or heart rate response. ADVANCE, a phase 3 trial stopped early after 43 patients, found aumolertinib with radiotherapy gave median progression-free survival of 34.0 vs 7.4 months against chemoradiotherapy in unresectable stage III EGFR-mutant lung cancer.