{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:56:56Z","timestamp":1791241016539,"version":"4.1.0"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"20","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>A large proportion of patients with pulmonary arterial hypertension (PAH) is treated with monotherapy although current treatment guidelines emphasize the importance of combination therapies to achieve the treatment goals. Because the reasons for physicians\u2019 treatment decisions in routine clinical practice are not well understood, factors influencing these decisions were investigated.<\/jats:p>\n                  <jats:p>In this multicentre, non-interventional study, 79 patients who started PAH therapy \u226412 months prior to study inclusion were enrolled. Data available per routine clinical practice were collected. Furthermore, physician\u2019s rationale for treatment decision was assessed. All analyses were descriptive.<\/jats:p>\n                  <jats:p>Patients\u2019 mean age was 64 years. Most patients were female (57.0%) with idiopathic PAH (76.0%) and had \u22655 comorbidities (64.6%). At therapy start the significant reasons for choosing combination therapy or monotherapy were patient\u2019s risk (81.5%; Odds ratio, OR: 12.38, p=0.0227) and comorbidity status (56.7%; OR: 0.07, p=0.0004), respectively. The proportion of patients receiving combination therapy increased from 45.6% at therapy start to 78.4% at month 24. Concomitantly, the percentage of low-risk patients increased from 14.5% to 35.1%. A significant greater percentage of patients on initial combination therapy achieved an improvement of World Health Organization functional class (85.2% and 50.0%, respectively; OR: 5.75, p=0.0357) between therapy start and end of observation. A low-risk status was achieved by 27.3% and 50.0% of patients on monotherapy and combination therapy, respectively.<\/jats:p>\n                  <jats:p>Risk and comorbidity status are the key factors for physicians\u2019 choice of treatment regimen. Findings from the study suggest that patients on initial combination therapy could potentially improve their clinical status more effectively, even when they have comorbidities.<\/jats:p>","DOI":"10.1055\/a-2893-7266","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T22:51:19Z","timestamp":1788994279000},"page":"e47-e55","source":"Crossref","is-referenced-by-count":0,"title":["Factors influencing treatment decisions in patients with pulmonary arterial hypertension"],"prefix":"10.1055","volume":"151","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7215-0943","authenticated-orcid":false,"given":"Hans","family":"Klose","sequence":"additional","affiliation":[{"name":"UKE: Univesit\u00e4tsklinikum Hamburg-Eppendorf, Germany","place":["Hamburg"],"department":["Klinik f\u00fcr Pneumologie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Roitenberg","sequence":"additional","affiliation":[{"name":"Janssen-Cilag GmbH","department":["a Johnson&Johnson Company"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay","family":"Kronberg","sequence":"additional","affiliation":[{"name":"Clinic Oldenburg, Clinic for Internal Medicine and Cardiology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"issue":"38","key":"ref1","doi-asserted-by":"publisher","first-page":"3618","DOI":"10.1093\/eurheartj\/ehac237","article-title":"2022 ESC\/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension","volume":"43","author":"M Humbert","year":"2022","journal-title":"Eur Heart J"},{"issue":"01","key":"ref2","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.healun.2022.10.003","article-title":"Risk stratification and response to therapy in patients with pulmonary arterial hypertension and comorbidities: A COMPERA analysis","volume":"42","author":"S 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A consensus statement from the Pulmonary Vascular Research Institute\u02bcs Innovative Drug Development Initiative\u2019s Real-world Evidence Working Group","volume":"13","author":"K Morland","year":"2023","journal-title":"Pulm Circ"}],"container-title":["DMW - Deutsche Medizinische Wochenschrift"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2893-7266.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:40:46Z","timestamp":1791240046000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2893-7266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":23,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2026,10,5]]},"published-print":{"date-parts":[[2026,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2893-7266","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0012-0472","1439-4413"],"issn-type":[{"value":"0012-0472","type":"print"},{"value":"1439-4413","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]}}}