Real-world experience of elderly patients with pulmonary arterial hypertension (PAH) initiating selexipag (EXPOSURE/EXTRACT studies)
Bibliographic record
Abstract
Real-world evidence is needed for better management of PAH in the growing elderly population, as clinical trials often exclude these patients. This analysis describes characteristics, treatment patterns and outcomes of PAH patients initiating selexipag in patients over 75 years old and the overall population. Pooled data from prospective EXPOSURE (EUPAS19085) and retrospective EXTRACT (EUPAS49227) observational PAH studies, in Europe and Canada, were used. As of 2023, 117/976 (12%) patients who initiated selexipag with follow up information were over 75 years old. Their characteristics are described in the Table. Selexipag was initiated as triple oral combination therapy in the vast majority (85%). During the median (Q1, Q3) exposure period of 7.9 (2.9, 22.6) months, 68 (58%) patients discontinued selexipag, including 29 (25%) due to tolerability/adverse event (AE); 29 patients died. One-year Kaplan-Meier (KM) survival estimate was 79%. In the overall population, the median (Q1, Q3) exposure period was longer (13.0 [4.1, 29.0] months), fewer patients discontinued selexipag (41%), including 167 (17%) due to tolerability/AE, and one-year KM survival estimate was higher (92%); 116 patients died. These data suggest selexipag is predominately initiated as triple combination therapy in elderly patients, with consideration needed for managing side effects to improve tolerability. erj;64/suppl_68/PA4317/F1 F1 F1
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".