Real-World Experience With Sotatercept in Pulmonary Arterial Hypertension: Hematologic Effects and Safety Considerations

Background: Sotatercept, a first-in-class activin signaling inhibitor, has demonstrated efficacy in pulmonary arterial hypertension (PAH) through randomized controlled trials.However, real-world data on its hematologic effects and tolerability are limited.This study aims to evaluate the hematologic outcomes and safety profile of sotatercept in a real-world cohort of PAH patients.Methods: We conducted a retrospective cohort study at the University of California, San Diego, from April 20, 2024, to February 28, 2025.Patients with PAH who initiated sotatercept at 0.3 mg/kg subcutaneously every 21 days were included.Dosage was increased to 0.7 mg/ kg if hemoglobin and platelet levels remained stable 2 weeks post-initial dose.Hematologic assessments were performed at baseline and every 2 weeks following each administration,