Initial combination therapy of macitentan and tadalafil in pulmonary arterial hypertension

Initial combination therapy plays a central role in managing pulmonary arterial hypertension (PAH) [1–4]. Patients with low- or intermediate-risk of 1-year mortality at diagnosis should be treated with initial combinaton therapy with an endothelin receptor antagonist (ERA) and phosphodiesterase type-5 inhibitor (PDE5i) [2–4]. Benefits of initial therapy with the ERA ambrisentan and PDE5i tadalafil were demonstrated in AMBITION [1]; prospective evidence for other treatment combinations within these drug classes is needed. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: Dr. Sitbon reports personal fees and non-financial support from Actelion Pharmaceuticals Ltd, during the conduct of the study; grants, personal fees and non-financial support from Actelion Pharmaceuticals, grants and personal fees from Bayer HealthCare, grants, personal fees and non-financial support from GlaxoSmithKline, grants and personal fees from Merck, personal fees and other from Arena Pharmaceuticals, personal fees from Gossamer Bio, personal fees from Ferrer, outside the submitted work. Conflict of interest: Dr. Cottin reports non-financial support from Actelion Pharmaceuticals Ltd, personal fees from Actelion Pharmaceuticals France Ltd, during the conduct of the study; personal fees and non-financial support from Actelion, grants, personal fees and non-financial support from Boehringer Ingelheim, personal fees from Bayer/MSD, personal fees from Gilead, personal fees from Novartis, grants, personal fees and non-financial support from Roche, personal fees from Sanofi, personal fees from Promedior, personal fees from Celgene, personal fees from Galapagos, personal fees from Galecto, outside the submitted work. Conflict of interest: Dr. Canuet reports non-financial support from Actelion Pharmaceuticals Ltd., personal fees from Actelion Pharmaceuticals France Ltd, during the conduct of the study; personal fees from Actelion Pharmaceuticals Ltd, outside the submitted work. Conflict of interest: Dr. Clerson reports personal fees and non-financial support from Actelion Pharmaceuticals Ltd., during the conduct of the study. Conflict of interest: Dr. Gressin reports personal fees and non-financial support from Actelion Pharmaceuticals Ltd., personal fees from Actelion Pharmaceuticals France, during the conduct of the study; personal fees and other from Actelion Pharmaceuticals Ltd., other from Idorsia Pharmaceuticals Ltd, personal fees and other from Actelion Pharmaceuticals France, outside the submitted work. Conflict of interest: Dr. Perchenet reports personal fees and non-financial support from Actelion Pharmaceuticals Ltd., during the conduct of the study; personal fees from Actelion Pharmaceuticals Ltd., outside the submitted work. Conflict of interest: Dr. Bertoletti reports non-financial support from Actelion Pharmaceuticals Ltd., during the conduct of the study; non-financial support from Actelion Pharmaceuticals Ltd., personal fees and non-financial support from Bayer, non-financial support from Pfizer, personal fees from Daichii-Sankyo, outside the submitted work. Conflict of interest: Dr. Bouvaist reports non-financial support from Actelion Pharmaceuticals Ltd., during the conduct of the study. Conflict of interest: Dr. Picard reports non-financial support from Actelion Pharmaceuticals Ltd., personal fees from Actelion Pharmaceuticals France Ltd, during the conduct of the study; personal fees and non-financial support from Novartis, outside the submitted work. Conflict of interest: Dr. Prevot reports non-financial support from Actelion Pharmaceuticals Ltd., personal fees from Actelion Pharmaceuticals France Ltd, during the conduct of the study. Conflict of interest: Dr. Bergot reports non-financial support from Actelion Pharmaceuticals Ltd., personal fees from Actelion Pharmaceuticals France Ltd, during the conduct of the study; personal fees and other from Chiesi Pharmaceuticals, personal fees from Actelion Pharmaceuticals Ltd., personal fees from Boehringer Ingelheim, personal fees from Roche, personal fees from Novartis, personal fees from Astra Zeneca, outside the submitted work. Conflict of interest: Dr. Simonneau reports non-financial support from Actelion Pharmaceuticals Ltd, personal fees and non-financial support from Actelion Pharmaceuticals France, during the conduct of the study; grants, personal fees and non-financial support from Actelion Pharmaceuticals Ltd, grants, personal fees and non-financial support from Bayer Healthcare, personal fees and non-financial support from MSD, personal fees and non-financial support from Acceleron, outside the submitted work.