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Article History

Received: 23 February 2026

Accepted: 8 June 2026

First Online: 16 July 2026

Declarations

Competing interests: Christian Botta, Maria Guido, and Søren Mellemkjær report no conflict of interest. Natalie Patzlaff, Scott Seaman, and Meredith Broderick are employees of United Therapeutics Corporation. Daniel Lachant is a site PI for ADVANCE (United Therapeutics Corporation) and reports financial support from Merck and Co. Inc. George Giannakoulas reports personal lecture/advisory fees from Actelion/Janssen, ELPEN Pharmaceuticals, Ferrer, Galenica, GossamerBio, GlaxoSmithKline, MSD, and United Therapeutics Corporation. Zeenat Safdar is a speaker and consultant for United Therapeutics Corporation, Johnson & Johnson, Boehringer Ingelheim, and Merck.

Ethics approval: An independent ethics committee (Office for Research Ethics Committees Northern Ireland) approved the study protocol (EudraCT Number: 2017-002639-40). The study was conducted in accordance with the Declaration of Helsinki and good clinical practice.

Consent to participate: All volunteers provided written informed consent.

Consent for publication: All the authors agree to publish the article.

Data availability: Interested researchers may submit a research proposal to the sponsor for review and consideration.

Code availability: Not applicable.

Author Contribution Statement: All authors contributed to the critical review, interpretation, and writing of this manuscript. All authors read and approved the final manuscript.