Pulmonary hypertension is abnormally high blood pressure in the arteries supplying the lungs, which forces the right side of the heart to work harder until it eventually fails. It has several distinct causes — some treatable, some not — and treatment has improved enormously over the past two decades.
What's actually going on in research
Sotatercept, an activin receptor ligand trap, has become the first drug to target the imbalance between cell growth and anti-growth signals in the pulmonary arteries, and it improves exercise capacity and outcomes on top of existing therapies. Combination approaches using endothelin receptor antagonists, PDE-5 inhibitors, and prostacyclin pathway drugs are now standard, and trials are testing new combinations and sequences. Gene therapy and cell therapy approaches targeting the underlying vascular biology are in early human trials.
Sotatercept
This first-in-class drug balances the growth signals that thicken pulmonary artery walls. Added to background therapy in trials, it improved walking distance and reduced the risk of clinical deterioration.
Upfront combination therapy
Starting with two or three pulmonary hypertension drugs simultaneously rather than sequentially is being tested to see if more aggressive early treatment prevents right heart failure.
Gene and cell therapy
Early trials are delivering genes or engineered cells to pulmonary artery walls to reverse the vascular remodeling that drives pressure elevation in heritable and idiopathic subtypes.
What to know before you search
Eligibility depends on pulmonary hypertension group and subtype, hemodynamics (mean PAP, PVR), 6-minute walk distance, background therapy, and WHO functional class.
What types of trials are currently open
- Drug trials — Testing new pulmonary vasodilators or combination strategies in pulmonary arterial hypertension.
- Right heart failure trials — Testing treatments for right ventricular failure complicating pulmonary hypertension.
- Group 2 and 3 trials — Testing approved and new drugs in pulmonary hypertension caused by left heart disease or lung disease.
- Surgical and intervention trials — Evaluating balloon pulmonary angioplasty and pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension.
- Observational studies — Tracking disease progression, outcomes, and long-term treatment responses across pulmonary hypertension groups.
Recently added Pulmonary Hypertension trials
Prevalence, Pathogenesis, and Prognosis of Pulmonary Hypertension in Dialysis Patients
This prospective multicenter longitudinal study aims to investigate the prevalence, pathogenesis, and prognosis of pulmonary hypertension in patients with end-stage renal disease undergoing chronic hemodialysis. The research seeks to identify specific clinical factors and biomarkers like angiopoietin-2 that contribute to the development of this condition, while evaluating the prognostic value of right ventricular function measured via TAPSE. Participants undergo a standardized screening echocardiogram the day after their intermediate dialysis session to determine the probability of pulmonary hypertension. Those identified as high-risk receive further diagnostic confirmation through right heart catheterization, respiratory function tests, and lung scans to clarify the underlying etiology. The protocol also evaluates the hemodynamic impact of high-flow arteriovenous fistulas and volume overload on pulmonary pressures. Clinical follow-up is conducted at baseline and subsequently at 6, 12, and 24 months to monitor patient outcomes and standardize therapeutic management according to established European guidelines.
Mechanistic Study of Nicotinamide Riboside on NAD+ Biology in Individuals With Combined Pulmonary Hypertension
Pulmonary hypertension (PH) is a serious condition that puts strain on the heart and lungs and often leads to frequent hospital stays and shortened life expectancy. The most common cause is heart disease affecting the left side of the heart. A particularly high-risk form, called combined pre- and post-capillary pulmonary hypertension (CPH), occurs in about one in four people with heart failure. There are currently no approved treatments for CPH, and many patients develop right-sided heart failure and die earlier than expected. This study is based on a new approach that uses advanced computer methods to analyze a patient's unique biology and identify potential drug targets. Using this method, we identified nicotinamide riboside (NR) as a promising option for people with CPH. NR is a form of vitamin B3 that helps the body make NAD⁺, a substance essential for how cells produce energy and stay healthy. NAD⁺ plays an important role in how heart and blood vessel cells function. Previous research in animals suggests NR may help improve blood vessel changes in the lungs and support heart function. NR has also shown potential benefits in human studies related to cell energy, mitochondrial health, and reducing oxidative stress. In this study, NR is used only as a dietary supplement that supports normal body processes, not as a proven treatment. The investigators will conduct a small, carefully controlled study in which participants receive NR and a placebo at different times. The goal is to understand how NR affects biological and biochemical markers in the body, not to test whether it improves symptoms or outcomes. Any clinical measurements are included only to help interpret the biological effects.
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