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Additional ligands are BMP\/TGF\u2010beta, GDF8, GDF11 and BMP10. The binding with activins leads to the inhibition of the signalling pathway and the deactivation of the bone morphogenic protein (BMP) receptor type 2. In this way, sotatercept activates an antiproliferative signalling to the cells of the pulmonary arteries and arterioles with the aim of rebalancing the proliferative and antiproliferative pathway that characterizes the pulmonary arterial hypertension (PAH). Sotatercept is indicated for the treatment of group 1 PAH in combination with drugs that act through the endothelin receptor, nitric oxide or prostacyclin. Its effects, demonstrated in the STELLAR study, are the improvement of exercise capacity and the FC\u2010WHO functional class, together with the reduction of the risk of clinical worsening events. In addition to its antiremodeling effects on the pulmonary circulation, sotatercept has several haematological effects that could suggest its use in the treatment of some blood disorders other than PAH. In this review, we will discuss the effects of the drug on PAH and in parallel provide an in\u2010depth overview of its application in haematological disorders, focusing on clinical and preclinical studies.<\/jats:p>","DOI":"10.1111\/eci.14386","type":"journal-article","created":{"date-parts":[[2025,1,18]],"date-time":"2025-01-18T09:43:17Z","timestamp":1737193397000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Sotatercept in pulmonary hypertension and beyond"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7877-0035","authenticated-orcid":false,"given":"Rosalinda","family":"Madonna","sequence":"first","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology and Critical Area, Cardiology Division University of Pisa  Pisa 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