Future Therapies for PAH: What’s on the Horizon?
Presented by Dr. Sanjay Mehta, MDCM, FRCPC, Southwest Ontario PH Clinic, London, ON
Background. Over more than 25 years of research and drug development, ten different PH-targeted medications have become available in Canada. Many Canadians living with PH have benefitted with fewer symptoms and limitations, better quality of life, and longer survival. Yet, many PH patients remain very ill and need new therapies. The current medications target three pathways in PAH: the prostanoid, endothelin, and nitric oxide (NO).
Current status. Active research has identified other key scientific abnormalities in PAH, which are now being targeted in human clinical trials. For example, the thickening and blockages of the blood vessels in the lungs (=pulmonary arteries) are due to the uncontrolled growth of smooth muscle cells and endothelial cells. Many chemicals in the body stimulate the growth of cells and can be targeted by medications. The drug sotatercept, injected under the skin (=subcutaneously), soaks up some of these chemicals (GDFs, activins) and improves many aspects of PAH, possibly reducing cell growth. There are many other exciting new therapies in current clinical studies, including kinase inhibitors (inhaled seralutinib and imatinib) and several Canadian-developed potential therapies, including olaparib (PARP-1 inhibitor), apabetalone (BRD4 inhibitor), intravenously injected gene-enhanced endothelial stem cells.
Future. Ongoing research is already developing new therapies, and we expect many more advances in PH treatment over the next five years, helping us further improve the lives of all Canadians living with PH.