Sotatercept

How it works

It acts as a ligand trap that binds activins and related growth factors, helping to rebalance pro- and anti-proliferative signalling in the pulmonary vasculature and reduce vascular remodelling.

Prescribing in practice

• It can raise haemoglobin and cause polycythaemia as well as thrombocytopenia and bleeding, so haematological parameters must be checked before and during treatment.
• It is used in addition to established background pulmonary arterial hypertension therapy under specialist supervision.
• Telangiectasia and bleeding events have been reported, and it may impair fertility and harm a developing fetus.

Monitoring

Monitor haemoglobin and platelet count before and during treatment, and watch for bleeding and signs of polycythaemia.

Counselling the patient

• This injection is added to your other pulmonary hypertension medicines.
• You will need regular blood tests to check your blood counts.
• Report any unusual bruising, bleeding, headaches or visual changes, and use effective contraception.

Evidence & guidelines

The STELLAR trial demonstrated improved exercise capacity with sotatercept added to background therapy in pulmonary arterial hypertension.