Editor’s Memo

Research has played a critical role in the advancement of care in patients with pulmonary hypertension. Studies suggest that enrollment into clinical trials is beneficial to participating patients¹ and that institutions participating in clinical trials have better disease-related outcomes.² I frequently tell my mentees that involvement in clinical research makes you a more thoughtful clinician and that working as a clinician makes you a savvier clinical researcher. This issue of Advances in Pulmonary Hypertension, guest edited by Drs. Cascino, Gomberg-Maitland and Pullamsetti, tackles several critical topics in pulmonary hypertension research.

Much has been learned about the pathophysiology of pulmonary arterial hypertension. Understanding the interface of the various pathways involved, however, can be overwhelming. The promise of multiomics, so elegantly described by Reem and colleagues in this issue, allows the integration of current knowledge for better disease targeting with therapy. This will make it easier to identify new paradigms of therapeutic approach, such as blocking tyrosine kinase, and with appropriate risk stratification, can encourage judicious use of combinations of different treatments based on clinical necessity. The hope is to one day be able to rapidly characterize patients and better identify the therapeutic approach that achieves the best clinical response, so-called precision medicine.³

For future studies to have applicability to our patient population, we must ensure enrollment of diverse patient populations. Gaps in minority patient enrollment are troubling, and Milinic and colleagues discuss potential solutions. The past decade has witnessed increasing challenges of patient recruitment, and many US studies have turned to the addition of international sites. It’s important to realize that such decisions can compromise the generalizability and applicability of results.⁴

Outcomes continue to steadily improve for patients diagnosed with pulmonary hypertension but remain far from optimal.⁵ Only through continued focus on research can further progress be achieved.