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Verfasst von:Nagel, Christian [VerfasserIn]   i
 Ewert, Ralf [VerfasserIn]   i
 Egenlauf, Benjamin [VerfasserIn]   i
 Lehmkuhl, Hans Brendan [VerfasserIn]   i
 Rosenkranz, Stephan [VerfasserIn]   i
 Benjamin, Nicola [VerfasserIn]   i
 Schwenger, Vedat [VerfasserIn]   i
 Herth, Felix [VerfasserIn]   i
 Grünig, Ekkehard [VerfasserIn]   i
Titel:Safety and efficacy of immunoadsorption as an add-on to medical treatment in patients with severe idiopathic pulmonary arterial hypertension
Verf.angabe:Christian Nagel, Ralf Ewert, Benjamin Egenlauf, Hans B. Lehmkuhl, Stephan Rosenkranz, Nicola Benjamin, Vedat Schwenger, Felix J. F. Herth, Ekkehard Grünig
E-Jahr:2017
Jahr:August 5, 2017
Umfang:9 S.
Teil:volume:94
 year:2017
 number:3
 pages:263-271
 extent:9
Fussnoten:Gesehen am 04.09.2018
Titel Quelle:Enthalten in: Respiration
Ort Quelle:Basel : Karger, 1944
Jahr Quelle:2017
Band/Heft Quelle:94(2017), 3, Seite 263-271
ISSN Quelle:1423-0356
Abstract:<b><i>Background:</i></b> Despite optimized medical therapy, severe idiopathic pulmonary arterial hypertension (IPAH) is a devastating disease with a poor outcome. Autoantibodies have been detected in IPAH that can contribute to worsening of the disease. <b><i>Objectives:</i></b> The objective of this prospective, open-label, single-arm, multicenter trial was to evaluate the safety and efficacy of immunoadsorption (IA) as an add-on to optimized medical treatment for patients with IPAH. <b><i>Methods:</i></b> A total of 10 IPAH patients received IA over 5 days. Their clinical parameters, including hemodynamics measured by right heart catheter, were assessed at baseline and after 3 and 6 months. The primary endpoint was the change in pulmonary vascular resistance (PVR). Secondary endpoints included the change in 6-min walking distance, quality of life, safety, and plasma levels of IgG and autoantibodies. <b><i>Results:</i></b> The evaluation of the 10 IPAH patients (75% female; 51 ± 12 years; 166 ± 10 cm; WHO functional class III; 53% on combination therapy) revealed that IA was a safe procedure that efficiently removed IgG and autoantibodies from the circulation. After 3 months, the mean PVR improved significantly by 13.2% (<i>p</i> = 0.03) and the cardiac index improved by 13.1%, but no significant changes were found in 6-min walking distance. The quality of life physical functioning subscale score significantly improved after 6 months. The serious adverse events in 3 patients were possibly related to IA and included pneumonia, temporary disturbance in attention, and thrombocytopenia. <b><i>Conclusions:</i></b> IA as an add-on to targeted medical treatment for IPAH is a safe procedure with beneficial effects on hemodynamics, especially in patients with high levels of autoantibodies. Larger-scale controlled studies are needed to assess its efficacy in IPAH and to identify responders.
DOI:doi:10.1159/000478744
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext ; Verlag: http://dx.doi.org/10.1159/000478744
 Volltext: https://www.karger.com/Article/FullText/478744
 DOI: https://doi.org/10.1159/000478744
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1580642845
Verknüpfungen:→ Zeitschrift

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