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Sotatercept is a recombinant activin receptor type IIA-Fc (ActRIIA-Fc) fusion protein used to treat pulmonary arterial hypertension (PAH). It acts as an activin signaling inhibitor by binding to activin A and other TGF-β superfamily ligands, thereby improving the balance between pro-proliferative (ActRIIA/Smad2/3-mediated) and anti-proliferative (BMPRII/Smad1/5/8-mediated) signaling pathways. This modulation helps reduce vascular proliferation, inflammation, and remodeling in the pulmonary arteries. In clinical trials, sotatercept has demonstrated significant improvements in exercise capacity, functional class, hemodynamics (notably reduction in pulmonary vascular resistance), and reduced risk of clinical worsening events[1][3][7]. Sotatercept is administered as a subcutaneous injection every three weeks.
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