| Online-Ressource |
Verfasst von: | Nagel, Christian [VerfasserIn]  |
| Ewert, Ralf [VerfasserIn]  |
| Egenlauf, Benjamin [VerfasserIn]  |
| Lehmkuhl, Hans Brendan [VerfasserIn]  |
| Rosenkranz, Stephan [VerfasserIn]  |
| Benjamin, Nicola [VerfasserIn]  |
| Schwenger, Vedat [VerfasserIn]  |
| Herth, Felix [VerfasserIn]  |
| Grünig, Ekkehard [VerfasserIn]  |
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 |
Safety and efficacy of immunoadsorption as an add-on to medical treatment in patients with severe idiopathic pulmonary arterial hypertension / Nagel, Christian [VerfasserIn]; August 5, 2017 (Online-Ressource)