; Chang, Hyuk-Jae
; Frantz, Robert P. ; Fukumoto, Yoshihiro ; Galié, Nazzareno
; Hassoun, Paul M. ; Klose, Hans ; Matsubara, Hiromi ; Morrell, Nicholas W.
; Peacock, Andrew J. ; Pfeifer, Michael ; Simonneau, Gérald ; Tapson, Victor F. ; Torres, Fernando ; Dario Vizza, Carmine ; Lawrence, David ; Yang, Wei ; Felser, James M. ; Quinn, Deborah A. ; Ghofrani, Hossein-Ardeschir 
| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | The Journal of Heart and Lung Transplantation | ||||
| Publisher: | ELSEVIER SCIENCE INC | ||||
| Place of Publication: | NEW YORK | ||||
| Volume: | 34 | ||||
| Number of Issue or Book Chapter: | 11 | ||||
| Page Range: | pp. 1366-1375 | ||||
| Date: | 2015 | ||||
| Institutions: | Medicine > Lehrstuhl für Innere Medizin II | ||||
| Identification Number: |
| ||||
| Keywords: | GROWTH-FACTOR EXPRESSION; 6-MINUTE WALK TEST; CONTROLLED-TRIAL; DOUBLE-BLIND; OPEN-LABEL; THERAPY; TREPROSTINIL; SURVIVAL; MESYLATE; PROSTACYCLIN; pulmonary arterial hypertension; imatinib; safety; long-term; efficacy | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 59978 |
Abstract
BACKGROUND: Imatinib is an oral inhibitor of several protein kinases implicated in the pathophysiology of pulmonary hypertension. Treatment with imatinib resulted in improved hemodynamics and exercise capacity in a controlled trial (Imatinib [QTI571] in Pulmonary Arterial Hypertension, a Randomized Efficacy Study [IMPRES]), among pulmonary arterial hypertension (PAH) patients inadequately ...

Abstract
BACKGROUND: Imatinib is an oral inhibitor of several protein kinases implicated in the pathophysiology of pulmonary hypertension. Treatment with imatinib resulted in improved hemodynamics and exercise capacity in a controlled trial (Imatinib [QTI571] in Pulmonary Arterial Hypertension, a Randomized Efficacy Study [IMPRES]), among pulmonary arterial hypertension (PAH) patients inadequately responsive to 2 to 3 PAH-specific therapies. METHODS: The long-term (up to 204 weeks) safety and efficacy of imatinib in this open-label extension study were reviewed until early study termination on April 16, 2014. Of 202 IMPRES-enrolled patients, 66 imatinib and 78 placebo recipients entered the extension. RESULTS: Overall, 93.8% (135 of 144) of patients discontinued the extension study; administrative issues (i.e., sponsor termination; 32.6%) and adverse events (31.3%) were the primary 'reasons for discontinuation. Nine patients completed the extension study before it was terminated. Serious and unexpected adverse events were frequent. These included 6 subdural hematomas in the extension study and 17 deaths during or within 30 days of study end. Although the patients who tolerated imatinib and remained in the extension for a longer duration did experience an improvement in functional class and walk distance, most discontinued the drug and the study. CONCLUSIONS: Severe adverse events, significant side effects, and a high discontinuation rate limit the utility of imatinib in the treatment of PAH. These risks outweigh any possible improvements in hemodynamics and walk distance seen in those patients able to remain on drug. The off-label use of this compound in PAH is discouraged. (C) 2015 International Society for Heart and Lung Transplantation. All rights reserved.
Metadata last modified: 19 Dec 2024 07:22
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