Approved PAH-specific therapies target 3 main biochemical pathways, offering opportunities for treatment with prostacyclin analogues; soluble guanylate cyclase (sGC) stimulators (riociguat [3]) or phosphodiesterase type 5 (PDE5) inhibitors (sildenafil and tadalafil); and endothelin receptor antagonists (ETRAs; bosentan, ambrisentan, and macitentan), respectively [1, 2]. The gene discussed is PDE5A; the disease is pulmonary arterial hypertension.