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Exploratory Post Hoc Analysis

Treat Early With UPTRAVI1

Time to first disease progression event in patients treated after 6 months of PAH diagnosis (UPTRAVI vs placebo)2
Percent of patients without an event on UPTRAVI vs placebo desktop curve Percent of patients without an event on UPTRAVI vs placebo desktop curve
Percent of patients without an event on UPTRAVI vs placebo desktop curve

Baseline patient characteristics2‡

Treated >6 months from diagnosis

65% (n=752/1156; 42% FC II and 56% FC III)§

Background therapy

  • 45% ERA + PDE5i (n=336/752)
  • 28% PDE5i (n=209/752)
  • 17% ERA (n=128/752)
  • 11% None (n=79/752)

Proven in a Broad Range of Patients1

GRIPHON is the largest PAH pivotal trial, studied as monotherapy, dual therapy (ERA or PDE5i), and triple therapy (ERA + PDE5i)1,2

GRIPHON: Multicenter, long-term, double-blind, placebo-controlled, parallel-group, event-driven, phase 3 trial1,3

1156 Patients

UPTRAVI (selexipag):
n=574

Placebo: n=582

Mean age:
48 years

Female:
80%

1.4 Years (median duration of exposure to UPTRAVI)

Longest endpoint evaluation period of any prostacyclin pathway therapy

0.9 Years 

Median time from PAH diagnosis in patients taking UPTRAVI

New England Journal of Medicine Clinical Trial Publication for GRIPHON

This article includes information that has not been approved by the Food and Drug Administration for UPTRAVI. Please see full Prescribing Information available on this website. Authors[s] of this article have received remuneration from Actelion Pharmaceuticals US, Inc., or its affiliates.

Proven in a Broad Range of Patients1

GRIPHON is the largest PAH pivotal trial, studied as monotherapy, dual therapy (ERA or PDE5i), and triple therapy (ERA + PDE5i)1,2

GRIPHON: Multicenter, long-term, double-blind, placebo-controlled, parallel-group, event-driven, phase 3 trial1,3

1156 Patients

UPTRAVI (selexipag):
n=574

Placebo: n=582

Mean age:
48 years

Female:
80%

1.4 Years (median duration of exposure
to UPTRAVI)

Longest endpoint evaluation period of any prostacyclin pathway therapy

0.9 Years 

Median time from PAH diagnosis in patients taking UPTRAVI

New England Journal of Medicine Clinical Trial Publication for GRIPHON

This article includes information that has not been approved by the Food and Drug Administration for UPTRAVI. Please see full Prescribing Information available on this website. Authors[s] of this article have received remuneration from Actelion Pharmaceuticals US, Inc., or its affiliates.

Summary of primary endpoint events in patients treated after 6 months of PAH diagnosis2

PRIMARY COMPOSITE ENDPOINT:
Morbidity/mortality up to end of treatment period||
UPTRAVI n=367,% (n)Placebo n=385,% (n)
All primary endpoint events26.7% (98)37.1% (143)
FIRST EVENT WAS
Hospitalization for PAH
14.7% (54)18.2% (70)
Other disease progression
(decrease in 6MWD plus worsening FC or need for other therapy)
6.3% 
(23)
13.5% (52)
Death3.8% (14)2.1% (8)
Parenteral prostanoid or chronic oxygen therapy1.6% (6)2.9% (11)
Need for lung transplantation or balloon atrial septostomy for worsening of PAH0.3% (1)0.5% (2)

Adverse reactions in >6 months from diagnosis subgroup occurring more frequently (≥3%) with UPTRAVI compared with placebo2

ADVERSE
REACTION
UPTRAVI n=368,% (n)Placebo n=381,% (n)
Headache68% (249)36% (136)
Diarrhea48% (177)22% (82)
Nausea39% (145)23% (87)
Pain in jaw31% (114)8% (29)
Vomiting20% (72)9% (35)
Pain in extremity19% (68)11% (42)
Myalgia18% (65)5% (20)
Flushing14% (53)6% (22)
Time to first disease progression event in patients treated within 6 months of PAH diagnosis (UPTRAVI vs placebo)2
Percent of patients without an event on UPTRAVI vs placebo desktop curve Percent of patients without an event on UPTRAVI vs placebo desktop curve
Percent of patients without an event on UPTRAVI vs placebo desktop curve

Baseline patient characteristics2‡

Treated ≤6 months from diagnosis

35% (n=404/1156; 52% FC II and 46% FC III)§

Background therapy

  • 41% PDE5i (n=165/404)
  • 39% None (n=157/404)
  • 10% ERA (n=42/404)
  • 10% ERA + PDE5i (n=40/404)

Proven in a Broad Range of Patients1

GRIPHON is the largest PAH pivotal trial, studied as monotherapy, dual therapy (ERA or PDE5i), and triple therapy (ERA + PDE5i)1,2

GRIPHON: Multicenter, long-term, double-blind, placebo-controlled, parallel-group, event-driven, phase 3 trial1,3

1156 Patients

UPTRAVI (selexipag):
n=574

Placebo: n=582

Mean age:
48 years

Female:
80%

1.4 Years (median duration of exposure to UPTRAVI)

Longest endpoint evaluation period of any prostacyclin pathway therapy

0.9 Years 

Median time from PAH diagnosis in patients taking UPTRAVI

New England Journal of Medicine Clinical Trial Publication for GRIPHON

This article includes information that has not been approved by the Food and Drug Administration for UPTRAVI. Please see full Prescribing Information available on this website. Authors[s] of this article have received remuneration from Actelion Pharmaceuticals US, Inc., or its affiliates.

Proven in a Broad Range of Patients1

GRIPHON is the largest PAH pivotal trial, studied as monotherapy, dual therapy (ERA or PDE5i), and triple therapy (ERA + PDE5i)1,2

GRIPHON: Multicenter, long-term, double-blind, placebo-controlled, parallel-group, event-driven, phase 3 trial1,3

1156 Patients

UPTRAVI (selexipag):
n=574

Placebo: n=582

Mean age:
48 years

Female:
80%

1.4 Years (median duration of exposure
to UPTRAVI)

Longest endpoint evaluation period of any prostacyclin pathway therapy

0.9 Years 

Median time from PAH diagnosis in patients taking UPTRAVI

New England Journal of Medicine Clinical Trial Publication for GRIPHON

This article includes information that has not been approved by the Food and Drug Administration for UPTRAVI. Please see full Prescribing Information available on this website. Authors[s] of this article have received remuneration from Actelion Pharmaceuticals US, Inc., or its affiliates.

Summary of primary endpoint events in patients treated within 6 months of PAH diagnosis2

PRIMARY COMPOSITE ENDPOINT:
Morbidity/mortality up to end of treatment period||
UPTRAVI n=207,% (n)Placebo n=197,% (n)
All primary endpoint events27.5% (57)50.3% (99)
FIRST EVENT WAS
Hospitalization for PAH
11.6% (24)19.8% (39)
Other disease progression
(decrease in 6MWD plus worsening FC or need for other therapy)
7.2% 
(15)
24.4% (48)
Death6.8% (14)5.1% (10)
Parenteral prostanoid or chronic oxygen therapy1.9% (4)1.0% (2)
Need for lung transplantation or balloon atrial septostomy for worsening of PAH0% (0)0% (0)

Adverse reactions in ≤6 months from diagnosis subgroup occurring more frequently (≥3%) with UPTRAVI compared with placebo2

ADVERSE
REACTION
UPTRAVI n=207,% (n)Placebo n=196,% (n)
Headache61% (126)27% (53)
Diarrhea32% (67)14% (28)
Nausea23% (48)10% (20)
Pain in jaw16% (32)7% (14)
Vomiting16% (32)7% (14)
Pain in extremity14% (29)2% (4)
Myalgia13% (27)7% (14)
Arthralgia13% (26)6% (11)
Nasopharyngitis10% (21)7% (13)
Flushing8% (17)4% (7)

The analysis described here is post hoc and exploratory. The subgroup was not prespecified for evaluation of the primary endpoint. Please note this analysis did not compare patients treated within 6 months of PAH diagnosis with patients treated after 6 months of PAH diagnosis. Sample size should be considered and results should be interpreted with caution.

Treat early with UPTRAVI1

Treat early with UPTRAVI

SEE THE TRIPLE COMBINATION DATA

*Adjusted for the following covariates: baseline PAH therapy, WHO FC, sex, race, age, etiology, geographical region, baseline 6MWD, and NT-proBNP. Not adjusted for multiplicity.

†Hazard ratio based on primary endpoint events up to the end of treatment.

‡Mean age for ≤6 months subgroup: UPTRAVI (44 years), placebo (44 years). Mean age for >6 months subgroup: UPTRAVI (50 years), placebo (50 years). FC II in ≤6 months subgroup: UPTRAVI (55%), placebo (49%). FC II in >6 months subgroup: UPTRAVI (44%), placebo (41%).

§This threshold has previously been used to define newly diagnosed patients with PAH.

‖Treatment period defined as 7 days since last intake of UPTRAVI or placebo.

6MWD=6-minute walk distance; CI=confidence interval; ERA=endothelin receptor antagonist; FC=Functional Class; GRIPHON=Prostacyclin (PGI2) Receptor Agonist In Pulmonary Arterial HypertensION; HR=hazard ratio; NT-proBNP=N-terminal pro-brain natriuretic peptide; PAH=pulmonary arterial hypertension; PDE5i=phosphodiesterase type-5 inhibitor; WHO=World Health Organization.

References: 1. UPTRAVI (selexipag) full Prescribing Information. Actelion Pharmaceuticals US, Inc. 2. Gaine S, Sitbon O, Channick RN, et al. Relationship between time from diagnosis and morbidity/mortality in pulmonary arterial hypertension: results from the phase III GRIPHON study. Chest. 2021;160(1):277-286.