Presentation Outline ICHP Annual Meeting September 13-15

70
60
50
40
30
20
10
Inhaled Iloprost Added to Bosentan
(STEP)
0
Mean 6MWD Change
from Baseline (m)
Bosentan
+ Iloprost
(n=32)
p=0.051 0 051
Bosentan
+ Placebo
(n=33)
1.00
0.75
0.50
0.25
*log-rank test.
McLaughlin VV, et al. Am J Respir Crit Care Med. 2006;174:1257-1263.
Proportion Free of
Clinical Worsening Iloprost
Placebo
p=0.02*
0.00
0 28 56 84
Time (d)
Inhaled Treprostinil Added to Bosentan or
Sildenafil (TRIUMPH)
Meters
30
25
20
15
10
5
Change in Peak 6MWD
by Specific Combination:
6
Background
sildenafil
Background
bosentan
Entire population
22
7
6
11
25
0
Day 1 Week 6
Time
Week 12
McLaughlin VV, et al. J Am Coll Cardiol. 2010;55:1915-1922.
19
9
20
Change from baselinee
> defined value (meterss)
% Achieving Specific
6MWD Improvements
Placebo
Inhaled treprostinil
50
12
31
45
14
35
40
17
37
35
22
39
30
28
43
25
32
48
20
32
52
0 20 40 60
Percentage of patients
Combination Therapy Caveats
• Experience evolving
• Most data from ‘add-on’ - ? De novo? Order?
• More drugs available
– more options
– more ways to get it wrong
• More questions than answers
• Costs/expenditures; third-party hurdles
Taichman DB. Ann Intern Med. 2008;149:583-585.
21