This module addresses the evolving management of patients who have achieved sustained clinical improvement but may experience treatment fatigue, adverse effects, or substantial treatment burden. It explores when therapy transition or de-escalation may be considered, emphasizing careful patient selection based on sustained clinical improvement, favorable risk status and hemodynamics, patient goals, and the ability to provide close follow-up. Because clinical worsening can occur during or after treatment transitions, the module reinforces ongoing reassessment of risk, functional capacity, biomarkers, cardiac findings, and treatment sustainability as essential components of long-term PAH management.

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