Management of pulmonary arterial hypertension: Current strategies and future prospects

Authors

Munish Sharma, Critical Care and Sleep Medicine, USA
Vivek Paudyal, Karnali Academy of Health Sciences, Nepal
Saifullah Khalid Syed, Indiana University School of Medicine, USA
Rubi Thapa, Karnali Academy of Health Sciences, Nepal
Nadeem KassamFollow
Salim Surani, Texas A&M, USA

Document Type

Article

Department

Internal Medicine (East Africa)

Abstract

Primary pulmonary hypertension (PPH), now known as pulmonary arterial hypertension (PAH), has induced significant treatment breakthroughs in the past decade. Treatment has focused on improving patient survival and quality of life, and delaying disease progression. Current therapies are categorized based on targeting different pathways known to contribute to PAH, including endothelin receptor antagonists (ERAs), phosphodiesterase-5 inhibitors (PDE-5 inhibitors), prostacyclin analogs, soluble guanylate cyclase stimulators, and activin signaling inhibitors such as Sotatercept. The latest addition to treatment options is soluble guanylate cyclase stimulators, such as Riociguat, which directly stimulates the nitric oxide pathway, facilitating vasodilation. Looking to the future, advancements in PAH treatment focus on precision medicine involving the substratification of patients through a deep characterization of altered Transforming Growth Factor-β(TGF-β) signaling and molecular therapies. Gene therapy, targeting specific genetic mutations linked to PAH, and cell-based therapies, such as mesenchymal stem cells, are under investigation. Besides prevailing therapies, emerging PH treatments target growth factors and inflammation-modulating pathways, with ongoing trials assessing their long-term benefits and safety. Hence, this review explores current therapies that delay progression and improve survival, as well as future treatments with curative potential.

Publication (Name of Journal)

Life

DOI

https://doi.org/10.3390/life15030430

Recommended Citation

Sharma, M., Paudyal, V., Syed, S. K., Thapa, R., Kassam, N., Surani, S. (2025). Management of pulmonary arterial hypertension: Current strategies and future prospects. Life, 15(3), 1-30.
Available at: https://ecommons.aku.edu/eastafrica_fhs_mc_intern_med/462

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.