This Week in Cardiology Oct 03 2025 This Week in Cardiology
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Oct 3, 2025 Discover two breakthrough drugs making waves in heart disease treatment, including sotatercept for pulmonary arterial hypertension and acoramidis for ATTR cardiomyopathy. Learn about the impactful HYPERION trial results and the cost dynamics affected by the ZENITH trial. John also dives into the complexities of pacing decisions after TAVI, detailing the PROMOTE study's findings and the uncertainty healthcare providers face. Plus, a teaser on upcoming discussions about GLP drugs in heart failure keeps the conversation lively!
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Sotatercept's Mechanism Reframes PAH
- Sotatercept targets activin/TGF-beta ligands to reduce proliferative signaling in pulmonary arterioles.
- This restores antiproliferative balance and can reverse vascular remodeling in PAH.
HYPERION Shows Large Clinical Benefit
- The HYPERION trial randomized 320 patients already on double or triple therapy and was stopped early for benefit.
- Sotatercept reduced clinical-worsening events from 37% to 10.6% with a hazard ratio of 0.24 and an NNT of ~5 at 12 months.
Account For Sotatercept Cost And Access
- Consider cost and access when adopting sotatercept because list price greatly exceeds ICER's estimated fair range.
- Refer patients and advocate for coverage solutions while recognizing pricing is a policy issue beyond direct clinical control.