Long-Term Outcomes of Selexipag in Schistosomiasis-Associated Pulmonary Arterial Hypertension

Inclusion Criteria Adults aged 18 years or older. * Confirmed diagnosis of pulmonary arterial hypertension associated with schistosomiasis (PAH-Sch). * Diagnosis of pre-capillary pulmonary arterial hypertension confirmed by right heart catheterization, performed at any time prior to the index date (T0), as documented in the medical record. * Evidence of schistosomiasis infection, including epidemiological history and ultrasonographic findings compatible with hepatosplenic schistosomiasis. * Previous antiparasitic treatment for schistosomiasis. * Clinical stability at the index date, defined as absence of progressive right heart failure or clinical worsening within the previous 12 weeks. * World Health Organization (WHO) functional class I-III at the index date. * Stable background pulmonary arterial hypertension-specific therapy with a phosphodiesterase-5 inhibitor and/or endothelin receptor antagonist for at least 12 weeks prior to the index date. * For the treated cohort: initiation of oral selexipag as part of routine clinical care. * For the mirror cohort: eligibility for therapeutic escalation at the index date without exposure to selexipag. Exclusion Criteria * World Health Organization (WHO) functional class IV at the index date. * Progressive right heart failure or clinical deterioration within the 12 weeks prior to the index date. * Documented formal contraindication to selexipag in the medical record. * Insufficient baseline data at the index date to allow clini…