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Vol. 44. Issue 12.
Pages 689-691 (January 2008)
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Vol. 44. Issue 12.
Pages 689-691 (January 2008)
Case Report
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Experience With Imatinib to Treat Pulmonary Arterial Hypertension
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Francisco José García Hernández
Corresponding author
fjgarciah@eresmas.com

Correspondence: Dr F.J. García Hernández Avda. de Andalucía, 72, bajo B 41700 Dos Hermanas, Sevilla, Spain
, María Jesús Castillo Palma, Rocío González León, Rocío Garrido Rasco, Celia Ocaña Medina, Julio Sánchez Román
Unidad de Colagenosis e Hipertensión Pulmonar, Servicio de Medicina Interna, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain
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Despite advances in the treatment of patients with pulmonary arterial hypertension (PAH), survival has not improved greatly. Imatinib, an antagonist of platelet-derived growth factor with antiproliferative activity, has been effective in experimental models and clinically in several published reports. We report the results of imatinib therapy in 4 patients with PAH (functional class IV) who were refractory to treatment with drug combinations for this condition. The final outcome was favorable in only 1 of the 4 cases. In this case, the patient was in functional class III and his hemodynamic parameters had improved significantly within 5 months after starting therapy. However, the patient died as a result of severe toxic hepatitis in which imatinib may have played a role. The present report adds to the few already in the literature (4 cases) and suggests that care should continue to be shown when using imatinib to treat PAH.

Key words:
Imatinib
Pulmonary arterial hypertension
Toxicity

A pesar de los avances en el tratamiento de los pacientes con hipertensión arterial pulmonar (HAP), su supervivencia sigue estando muy afectada. El imatinib, un antagonista del factor de crecimiento derivado de las plaquetas con acción antiproliferativa, ha sido eficaz en modelos experimentales y en algunos casos comunicados. Se describe el resultado del tratamiento con imatinib en 4 pacientes con HAP en clase funcional IV y refractarios al tratamiento con asociaciones de medicamentos para la HAP. La respuesta final fue favorable sólo en uno de los 4 casos, que 5 meses después de iniciado el tratamiento estaba en clase funcional III y con mejoría significativa de los parámetros hemodinámicos. Sin embargo, el paciente falleció por hepatitis tóxica grave en la que el imatinib pudo haber participado. Estos resultados se añaden a la escasa experiencia clínica comunicada (sólo otros 4 casos) e indican que debemos mantener la cautela sobre la utilidad del imatinib en el tratamiento de la HAP.

Palabras clave:
Imatinib
Hipertensión pulmonar
Toxicidad
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Copyright © 2008. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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