Circulation, Ahead of Print. Background: Combined post- and pre-capillary pulmonary hypertension in heart failure with preserved ejection fraction (CpcPH–HFpEF) involves remodeling in both the heart and pulmonary vasculature.
Despite significant mortality, there are no proven therapies.Methods: In this multicenter, randomized, placebo-controlled, phase 2 trial, adults received sotatercept (0.3 or 0.7 mg/kg) or placebo every 3 weeks. The primary end point was change in pulmonary vascular resistance at week 24.
Hodges–Lehmann shift estimates described placebo-adjusted changes.Results: 164 patients were randomized 54:55:55 to sotatercept 0.3 mg/kg, 0.7 mg/kg, and placebo, and baseline median pulmonary vascular resistance was 5.2 (interquartile range [IQR] 4.0–6.9) Wood units. The median change from baseline in pulmonary vascular resistance at week 24 was –0.67 Wood units in the sotatercept 0.3 mg/kg group, –0.33 Wood units in the sotatercept 0.7 mg/kg group, and 0.26 Wood units in the placebo group.
The Hodges–Lehmann shift estimates in pulmonary vascular resistance were –1.02 Wood units (95% CI, –1.81 to –0.23;P=0.004) for 0.3 mg/kg and –0.75 Wood units (95% CI, –1.52 to 0.03;P=0.024) for 0.7 mg/kg sotatercept.
Circulation published a clinical update in Cardiology on 29 Mar 2026.
The item focuses on Sotatercept for Combined Post- and Pre-capillary Pulmonary Hypertension Associated With Heart Failure: Results from the Phase 2, Randomized, Placebo-Controlled CADENCE Study.
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