Since sotatercept received Food and Drug Administration (FDA) approval for pulmonary arterial hypertension in March 2024, knowing when and how to use it has become an essential part of managing this serious condition — so say the authors of a recently published article in CHEST, who offer a practical guide for clinicians navigating this new treatment landscape.
The authors stress that sotatercept’s real-world impact will ultimately depend on how well clinicians identify and manage pulmonary arterial hypertension patients in the first place. Underdiagnosis and undertreatment remain persistent challenges, and it is essential to distinguish pulmonary arterial hypertension clearly from other forms of pulmonary hypertension in which sotatercept has not been studied or shown benefit. High-risk patients not yet on parenteral prostacyclin should be treated promptly and aggressively, and common comorbidities such as obesity, hypertension, diabetes, and atrial fibrillation should not be seen as barriers to pulmonary arterial hypertension therapy.
The authors conclude that using sotatercept thoughtfully, within a risk-based care framework and with timely referral to expert centres, is where pulmonologists can make the greatest difference in their patients’ lives.
Read the full article at this link on CHEST Pulmonary Perspectives
Talking to patients
We found this section very interesting. The authors offer some practical suggestions for shared decision-making. Rather than quoting clinical statistics, they recommend translating data into everyday terms — for instance, describing the improvement in walk distance as roughly the length of a grocery store aisle. They also suggest highlighting the reduction in hospitalisations, which patients tend to find particularly meaningful, and pointing out that a subcutaneous injection every three weeks fits easily into most daily routines. Understanding each patient’s lifestyle, work schedule, and personal goals should guide the conversation.
Citation
Sotatercept in pulmonary arterial hypertension, A step-by-step approach for considering the new kid on the block
Rodolfo A. Estrada, MD, FCCP; Sandeep Sahay, MD, MSc, FCCP; Adriano R. Tonelli, MD, CHEST, Pulmonary Perspectives, March 4, 2026