2021年 · 第44卷第06期

In early summer, the heat is gradually growing. Recent news of the novel coronavirus (SARS-CoV-2) variant strain and the discovery of sporadic cases in some provinces and cities in China are touching people's hearts. Professor Liu Youning, the editor-in-chief essay column of this issue, shouted loudly, emphasizing that "Chinese people should be universally vaccinated against novel coronavirus" and "fight as hard as possible". In view of the current paralysis and carelessness in China due to the overall stable situation, he once again emphasized that "there is a long way to go". The medical community should have a clear understanding of this and recommend reading.

Background and PurposePulmonary hypertension is characterized by pulmonary vascular remodeling, cell proliferation, and poor long-term prognosis. Bone morphogenetic protein signaling pathway dysfunction is associated with two subtypes, hereditary and idiopathic. Sotatercept is a novel fusion protein that binds to activin and growth differentiation factors to restore the balance between the growth-promoting and growth-inhibiting signaling pathways of bone morphogenetic protein type II receptors. Methods In a 24-week multicenter trial, 106 adult patients undergoing background treatment for pulmonary hypertension were randomly assigned to 3 groups: sotatercept low-dose [sotatercept subcutaneously administered at 0.3 mg/kg (body weight) every 3 weeks], sotatercept high-dose [sotatercept subcutaneously administered at 0.7 mg/kg (body weight) every 3 weeks], and placebo. The primary endpoint was change in pulmonary vascular resistance from baseline to week 24.resultBaseline characteristics were similar in the three groups of patients. The least squares mean difference in changes in pulmonary vascular resistance from baseline to 24 weeks was-145.8 dyn·sec·cm between Sotatercept low-dose and placebo^-5(95% CI: -241.0 to-50.6,P=0.003）。 The least squares mean difference between Sotatercept high-dose group and placebo group was-239.5 dyn·sec·cm^-5（95%CI：-329.3~-149.7，P<0.001）。 At 24 weeks, the least squares mean difference in 6-min walk distance change was 29.4 m (95% CI: 3.8 to 55.0) between the Sotatercept low-dose and placebo groups and 21.4 m (95% CI: 3.8 to 55.0) between the Sotatercept 0.7 mg/kg and placebo groupsCI-2.0 to 45.7). Sotatercept was also associated with a decrease in N-terminal brain natriuretic peptide levels. The most common hematological adverse events were thrombocytopenia and elevated hemoglobin levels. One patient in the Sotatercept 0.7 mg/kg group died of cardiac arrest.conclusionTreatment with Sotatercept reduces pulmonary vascular resistance in patients undergoing background therapy for pulmonary hypertension.