However, three of the novel large PAH trials—namely GRIPHON23, SERAPHIN24, and AMBITION25—have clearly shown the value of oral PAH combination therapy, with selexipag plus PDE5 blockers or ERAs or both, the ERA macitentan plus PDE5 inhibitors, and the ERA ambrisentan plus the PDE5 inhibitor tadalafil, respectively. Here, PDE5A is linked to pulmonary arterial hypertension.