• November 2019

    Pulmonary hypertension clinic expands clinical, research options for Texas patients

Despite the availability of pulmonary arterial hypertension (PAH)-targeted therapeutic options over the past twenty years, there is general consensus around shortcomings with regards to PAH diagnosis and management.

The Pulmonary Hypertension (PH) program at Baylor Scott & White The Heart Hospital Plano is working to address these shortcomings. As one of only two Pulmonary Hypertension Association (PHA)-accredited sites in North Texas, The Heart Hospital’s unique offering combines clinical and research programming to help increase access to care, provide a more timely diagnosis, and initiate treatments proven to be effective in prolonging life

Dr. Sahil Bakshi oversees the program which treats patients from across Texas and neighboring states. He is a part of the comprehensive consultation process – which also includes an evaluation from other providers involved in the patient’s care, such as the patient’s cardiologist, pulmonologist, and critical care specialist.

This integrated approach has led to the PH program being the only North Texas provider recognized as a Pulmonary Hypertension Care Center with RCP designation. Since its inception seven years ago, the PAH patient population at Baylor Scott & White The Heart Hospital Plano has continued to increase, and the availability of advanced therapies has expanded to include all FDA approved treatment modalities. 

“PH is in a unique place,” explains Dr. Bakshi. “Prevalence is rising, but the driver is not a growing epidemic, it is education. Awareness is at an all-time high, so physicians are getting better at recognizing the condition. The focus now must be on getting these diagnosed patients to sites that are best equipped to treat their condition.”

Dr. Bakshi says their team consults with other cardiologists and pulmonologists, even rheumatologists and surgeons, on cases for PH patients. “We work with many physicians who recognize that their patient is presenting with something akin to perhaps severe asthma or even COPD – dyspnea of unknown origin, essentially. Standard therapies and treatments are proving ineffective, and while they have a workup, they don’t necessarily know how to assess it based on these factors.” This “phone a friend” dynamic has continued to rise since the program received its accreditation. He believes the accreditation and RCP designation has empowered other physicians to take action and know precisely where to send patients for treatment or consultation.

In addition to its clinical program, the team also pursues research aimed at improving knowledge around therapeutic options, treatment outcomes over time, and the etiology of PAH.

The team is in the process of establishing a repository of biological samples, as well as both clinical and genetic data from subjects with PAH, for precisely this effort. Collectively, insights and findings derived from these efforts will help determine what the best care options are for their patients and what future research endeavors their team pursues.

Currently, the site is also involved in a prospective observational drug registry developed to, 1) characterize the safety profile (including primarily potential serious hepatic risks), and 2) to describe clinical characteristics and outcomes of patients newly treated with macitentan in the post-marketing setting. “In the last 20 years, we have had many therapies introduced, but it’s critical we continue to optimize the medicine. We have to think about if dosing standards should be amended, and the patient mortality benefit – yes, the drugs have been proven safe and people are doing well, but for how long are they doing well and how long do they stay out of the hospital? Those are questions our research can help answer.”

For more information about the program, including active research efforts and clinical care offerings, please contact: Adrian.Felder@BSWHealth.org.