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Article History

Received: 10 November 2025

Accepted: 23 January 2026

First Online: 10 March 2026

Change Date: 4 April 2026

Change Type: Update

Change Details: This article was revised due to rename the Supplement Material link

Declarations

:

: Meredith Broderick, Dasom Lee, Kevin Maher, Andrew Nelsen, Franck Rahaghi, and Claire M. Thrasher are employees of the study sponsor, United Therapeutics. Danielle Caudell Stamper, is an employee of the study’s clinical research organization contracted by the study sponsor. Hunter Champion has received consulting fees and payment for speakers’ bureaus from United Therapeutics. Maral DerSarkissian has received consulting fees from United Therapeutics. David G. Kiely has received funding from NIHR Sheffield Biomedical Research Centre, Janssen, and Ferrer; consulting fees from Janssen, Ferrer, Altavant, MSD, United Therapeutics, Liquidia, Gossamer Bio, and Apollo; payment for presentations, manuscript writing, or events from Janssen, Ferrer, Altavant, MSD, and United Therapeutics; participated in a Data Safety Monitoring or Advisory Board for Janssen, MSD, and Liquidia; and is a member of the Clinical Reference Group for Specialised Respiratory Medicine (NHS England) and leads the UK National Audit of Pulmonary Hypertension. Tejaswini Kulkarni has received consulting fees from and participated in an Advisory Board for United Therapeutics. Steven Nathan has received consulting fees, payment for expert testimony and payment for presentations, manuscript writing, or events from United Therapeutics; participated in a Data Safety Monitoring or Advisory Board for United Therapeutics, AbbVie, and BMS; has stock in and holds a leadership or fiduciary role at Gossamer Bio. Raj Parikh has received payment for presentations, manuscript writing, or events from Janssen and United Therapeutics; and participated in a Data Safety Monitoring or Advisory Board for United Therapeutics and Liquidia. Sandeep Sahay has received funding from Merck, United Therapeutics, Gossamer Bio, Keros, Pulmovant, Liquidia, and Respira; consulting fees from Merck and United Therapeutics; support for meeting attendance or travel from Janssen; participated in Advisory Boards for United Therapeutics, Liquidia, and Data Safety Monitoring Board for NIH-funded trials; and holds a leadership role at ACCP CHEST and PHA. Mary Beth Scholand has received consulting fees from Boehringer Ingelheim, Genentech, Veracyte, Imvaria, and United Therapeutics. Oksana A. Shlobin has received consulting fees from Merck, Insmed, and AllRock; payment for speakers’ bureau from United Therapeutics; participated in a Data Safety Monitoring or Advisory Board for Janssen and GSK; and holds a leadership or fiduciary role at PHA and ACCP CHEST. David Zisman has received funding from the Jean and William Soman Research Fund. Debabrata Bandyopadhyay, Amro Al-Astal, Matthew Hunsucker, and Abhijit Raval have nothing to disclose.

: Ethical oversight for this study was provided by Advarra, serving as the Central Institutional Review Board (IRB) and local IRB approval was obtained for some sites. The study was approved by all participating institutions and site-level IRB approval details can be found in Table S1 of the Online Data Supplement. Written informed consent was obtained from all study participants, and all procedures involving human participants were performed in accordance with the ethical standards of each institution and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.