Late Breaking Abstract - Balloon pulmonary angioplasty versus riociguat for the treatment of inoperable chronic thromboembolic pulmonary hypertension: results from the randomised controlled RACE study

Background: Medical therapy with riociguat and balloon pulmonary angioplasty (BPA) are two therapeutic options for inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Controlled studies comparing these two treatments are lacking. Methods: The multicenter, randomised, controlled RACE trial evaluated the efficacy and safety of riociguat versus BPA in newly diagnosed and treatment-naive patients with CTEPH adjudicated as inoperable. Patients identified as WHO functional class (FC) I-IV with a pulmonary vascular resistance (PVR) >320 dyn.s/cm5 were randomly assigned, in a 1:1 ratio, to receive a treatment with riociguat or BPA. The primary endpoint was resting PVR at week 26, expressed as percentage of PVR at baseline. Secondary endpoints included changes from baseline in 6-min walk distance (6MWD), WHO FC, NT-proBNP, time to clinical worsening, and safety. Results: Between January 2016 and January 2019, 105 patients were randomised in 14 centers belonging to the French Pulmonary Hypertension Network: 53 to riociguat, 52 to BPA. Baseline characteristics are depicted in the table. The full study results will be available in June 2019. Conclusion: RACE study will provide important informations on the effect of riociguat compared to that of BPA as first-line therapy in treatment-naive patients with inoperable CTEPH.