Community-Acquired Pneumonia (CAP)

Insmed Stock Soars On Pulmonary Arterial Hypertension Drug Trial Results

Shares of Insmed (INSM) jumped nearly 30% Tuesday after the biopharmaceutical company reported positive results from a Phase 2 trial for its treatment of pulmonary arterial hypertension.

The Bridgewater, N.J.-based company said the study was "evaluating the efficacy and safety of treprostinil palmitil inhalation powder" in patients with pulmonary arterial hypertension, or PAH, and that the trial "met its primary endpoint and all secondary efficacy endpoints."

Pulmonary hypertension, which develops when the blood pressure in your lungs is higher than normal, affects about 1% of people globally, per the National Heart, Lung, and Blood Institute.

Insmed said it would "immediately engage with the U.S. Food and Drug Administration (FDA) regarding the Phase 3 trial design for PAH. Insmed plans to initiate a Phase 3 trial in patients with pulmonary hypertension associated with interstitial lung disease before the end of 2025 and a Phase 3 trial in patients with PAH in early 2026."

The news caused Insmed shares to soar nearly 28% Tuesday afternoon to around $90, their highest level in nearly a quarter century.

Shares of United Therapeutics (UTHR), which makes rival PAH treatments, recently sank almost 14% to about $283, their lowest level since April.

Our Son, 13, Cried Out 'mum, Help' Before He Suddenly Died – He'd Gone To 'rest In Bed' Just Hours Before

A SCHOOLBOY, who told his parents he was going to "rest in bed" after suffering with a cough and temperature, suddenly died "out of nowhere".

Tomas Remeikis, 13, collapsed in his bedroom as his parents frantically tried to save him.

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Tomas Remeikis was diagnosed with pulmonary hypertension when he was younger - but successful surgery and medication helped manage the condition for many yearsCredit: Funeral-Notices UK

Despite being rushed to hospital, he tragically died on May 26.

Tomas was diagnosed with pulmonary hypertension as a child after doctors discovered a hole in his heart.

But despite his diagnosis, Tomas lived a healthy life for many years - cycling to school every day and attending taekwondo classes twice a week.

Pulmonary hypertension is a condition that affects the blood vessels in the lungs, and in children can stem from various underlying conditions, including congenital heart defects, lung diseases, and genetic factors.

When Tomas, who was born in Manchester but moved to Southport two years ago, was a young child he often experienced shortness of breath and tiredness - two symptoms of pulmonary hypertension.

His dad, Andrius Remeikis, told Liverpool Echo: "He was just ill all the time but we thought it was chest infections."

When Tomas was three years old, his granddad became worried about him as he played on his scooter.

"Tomas used to stop to catch breath and his granddad became a bit suspicious," Andrius said. "He said, he shouldn't be so tired."

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Pulmonary hypertension can lead to serious complications like heart failure, which can be fatal. 

When Tomas' hole in his heart was discovered, he underwent urgent surgery, which was successful.

Understanding blood clots

He was then required to take medication every day and also received regular checkups at Great Ormond Street Hospital in London.

Following the surgery, once or twice a year Tomas would feel dizzy.

But nothing would show up in tests and he otherwise appeared stable.

Around a week before his death, Tomas started feeling poorly with a cough and a temperature, but soon felt better.

However, he fell ill again on the Bank Holiday Monday in late May.

Andrius said: "I had just made breakfast and he wasn't feeling well. I asked the same questions about his lungs and heart but he just had a cough.

"He said, I'll go rest in bed for a bit. In the afternoon he got up again and I made him some tea. I asked how he was feeling and he said, maybe a bit better.

He shouted, 'mum, help' and we called the ambulance. Then he lost consciousness

Andrius Remeikis

"Then it just all happened all of a sudden. I was with my wife and we decided to go to the hospital. She started getting his trousers out and then she shouted at me, saying, his lips are getting blue. He shouted, 'mum, help' and we called the ambulance. Then he lost consciousness."

An ambulance arrived to take Tomas to hospital, but his family aren't exactly sure when or why he died.

While a post-mortem has said it looks like his heart failed, the cause of death will be determined by an inquest.

Tomas' family has asked for donations to the Pulmonary Hypertension Association, who supported him throughout his life.

His heart will be donated to them for medical research.

Andrius said: "Tomas was kind, friendly, loving and outgoing. He really got along with everyone that he came in contact with. Anyone who spent time with him loved him."

Warning signs of pulmonary hypertension

PULMONARY hypertension is high blood pressure in the blood vessels that supply the lungs (pulmonary arteries).

It's a serious condition that can damage the right side of the heart.

The changes in the pulmonary arteries that lead to pulmonary hypertension can be caused by:

various conditions that cause problems with the smaller branches of the pulmonary arteries (PAH)

conditions that affect the left side of the heart

lung diseases or a shortage of oxygen in the body (hypoxia)

blood clots that cause narrowing or a blockage in the pulmonary arteries

Symptoms include:

shortness of breath

tiredness

feeling faint or dizzy

chest pain (angina)

a racing heartbeat (palpitations)

swelling (oedema) in the legs, ankles, feet or tummy (abdomen)

If you have any symptoms you should see a GP.

If you get sudden chest pain that does not stop after a few minutes, or you have heart palpitations with chest pain, shortness of breath or feeling faint call 999 or go to A&E.

These could be a sign of another condition such as a blood clot in your lungs or a serious heart problem.

Source: NHS

Atrial Fibrillation Linked To Risk For Incident Pulmonary Hypertension

Atrial fibrillation (AF) is associated with risk for pulmonary hypertension (PH), and incident venous thromboembolism (VTE) further elevates that risk, according to results of a study in the Journal of the American Heart Association.

Researchers assessed incident PH in patients diagnosed with AF compared with a matched control population without AF using the Swedish National Patient Register (NPR).

Data were obtained for all reported first cases of AF as a primary or a secondary diagnosis from January 1, 1987, to December 31, 2013. The cases were matched based on sex, age, and county with 2 control individuals without AF from the Swedish Population Register.

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Clinically, these findings highlight the need for closer monitoring and early intervention in patients with AF to mitigate the progression to PH, especially in those with concurrent VTE.

The patients with AF and matched control participants were followed until a first event of PH, death, or end of study on December 31, 2013.

The cohort included 521,988 first AF cases (age 35 to 85 years) without a previous PH or VTE diagnosis and 1,017,277 non-AF control individuals. Their mean age was 71.1 (SD, 10.1) and 71.0 (SD, 10.1) years for the AF and control group, respectively, and 43% were women in both groups.

After a median follow-up of 11 years, the AF group had 4454 (0.9%) PH events compared with 1855 (0.2%) in the control group. Among the events, 308 (0.06%) and 141 (0.01%) were primary PH (pulmonary arterial hypertension), and 4146 (0.8%) and 1714 (0.2%) were secondary or unspecified PH in the AF and control groups, respectively. Median CHA2DS2-VASc scores were 3 in the AF group compared with 2 in the control group.

The hazard ratio (HR) for PH in AF cases compared with non-AF control individuals was 4.7 (95% CI, 4.4-5.0) in the model adjusted for age and sex and 3.6 (95% CI, 3.4-3.9) in the model adjusted for relevant comorbidities according to the Cox proportional regression analysis.

Among control participants with an incident VTE, the HR for PH was 3.48 (95% CI, 3.05-3.97), and individuals with AF and an incident VTE had a HR of 1.96 (95% CI, 1.77-2.17) for PH. AF alone was associated with a HR of 3.97 (95% CI, 3.72-4.24). Compared with the control group without incident VTE, patients with AF and incident VTE had a HR of 7.78 (95% CI, 6.97-8.69).

Among several study limitations, the control cohort was overall healthier, and the incidence of PH is likely to be underestimated. Also, data were lacking on adherence to oral anticoagulant treatment.

"Clinically, these findings highlight the need for closer monitoring and early intervention in patients with AF to mitigate the progression to PH, especially in those with concurrent VTE," the study authors wrote.

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