Real-world Persistence on Selexipag for Pulmonary Arterial Hypertension in Canada
Bibliographic record
Abstract
Background: Safety and tolerability of selexipag in pulmonary arterial hypertension (PAH) was demonstrated in a phase 3 clinical trial. In this trial, up to 14% of patients receiving selexipag over a median period of 70 weeks prematurely discontinued therapy due to adverse events. However, no data are available on real-world persistence on selexipag in Canada. This study aimed to describe selexipag short and long-term persistence, and predictors of persistence in the Canadian population. Methods: This retrospective claims-database analysis included adult PAH patients with ≥ 1 selexipag claim between April 2016 and July 2021. Patients were followed for a maximum of 64 months. Kaplan-Meier estimates of persistence were calculated from the index date to the earliest date of discontinuation or censoring. Four models were used to select predictors of persistence, and the 12 most important features based on average rank were built into a Cox proportional hazards model to assess the impact of these predictors on patient persistence with selexipag. Results: A total of 311 patients (70% female; 71% aged 50-79 years) were included in the study. The Kaplan-Meier estimates of persistence at 6, 12, 24, and 36 months were 76.1%, 61.7%, 48.3%, and 40.2% respectively. The median duration of persistence for the overall cohort was 22 months. No predictors in the final model were significant. Conclusions: Real-world data from the Canadian population suggest a low level of long-term persistence on selexipag, although the level of persistence is similar to reported rates for other PAH therapies. Further research into predictors of selexipag persistence is needed to help optimize potential treatment outcomes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".