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Pulmonary arterial hypertension in patients treated by dasatinib.
Montani D., Bergot E., Günther S., Savale L., Bergeron A., Bourdin A., Bouvaist H., Canuet M., Pison C., Macro M. et al
Circulation 125, 17 (2012) 2128-37 - http://www.hal.inserm.fr/inserm-00697146
(22451584)
Pulmonary arterial hypertension in patients treated by dasatinib.
David Montani1, Emmanuel Bergot2, Sven Günther1, Laurent Savale1, 3, Anne Bergeron4, Arnaud Bourdin5, Helene Bouvaist6, Matthieu Canuet7, Christophe Pison8, Margareth Macro9, Patrice Poubeau10, Barbara Girerd1, 3, Delphine Natali1, 3, Christophe Guignabert1, 3, Frédéric Perros1, 3, Dermot S O'Callaghan1, 3, Xavier Jaïs1, 3, Pascale Tubert-Bitter11, Gérard Zalcman2, Olivier Sitbon1, 3, Gérald Simonneau1, 3, Marc Humbert () 1, 3
1 :  Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique
http://www.htapfrance.com/je-m-informe/voies_de_recherche.asp?rubrique=2
INSERM : U999 – Centre chirurgical Marie Lannelongue
133 avenue de la Résistance, 92350 Le Plessis-Robinson
France
2 :  Service de pneumologie (Caen)
CHU Caen – Centre Régional de Compétence de l'HTAP – Université de Caen Basse-Normandie – INSERM : ER3
Caen
France
3 :  Service de pneumologie et Réanimation Respiratoire
Assistance publique - Hôpitaux de Paris (AP-HP) – DHU Thorax Innovation – Hôpital Bicêtre
78 rue du Général Leclerc 94270 Le Kremlin-Bicêtre
France
4 :  Service de pneumologie
Université Paris VII - Paris Diderot – Hôpital Saint-Louis
Paris
France
5 :  Service de pneumologie (Montpellier)
Hôpital Arnaud de Villeneuve
Montpellier
France
6 :  Service de Cardiologie
CHU Grenoble
Grenoble
France
7 :  Service de pneumologie (Strasbourg)
Nouvel Hôpital Civil – CHU Strasbourg – Université de Strasbourg
1 place de l'hôpital 67091 Strasbourg Cedex
France
8 :  Service de pneumologie (Grenoble)
CHU Grenoble
Pavillon Dauphiné, BP 217 38043 Grenoble cedex 09
France
9 :  Service Hématologie Clinique
CHU Caen
Direction de la recherche clinique Avenue de la Côte de Nacre 14033 CAEN cedex 9
France
10 :  Service de Pneumologie et Maladies Infectieuses
Groupe Hospitalier Sud Réunion (GHSR)
97410 Saint pierre
Réunion
11 :  CESP - Centre de recherche en épidémiologie et santé des populations
INSERM : U1018 – Université Paris XI - Paris Sud – Hôpital Paul Brousse – Assistance publique - Hôpitaux de Paris (AP-HP)
16 avenue Paul Vaillant Couturier 94807 Villejuif Cedex, France
France
BACKGROUND: The French pulmonary hypertension (PH) registry allows the survey of epidemiological trends. Isolated cases of precapillary PH have been reported in patients who have chronic myelogenous leukemia treated with the tyrosine kinase inhibitor dasatinib. METHODS AND RESULTS: This study was designed to describe incident cases of dasatinib-associated PH reported in the French PH registry. From the approval of dasatinib (November 2006) to September 30, 2010, 9 incident cases treated by dasatinib at the time of PH diagnosis were identified. At diagnosis, patients had moderate to severe precapillary PH with functional and hemodynamic impairment. No other incident PH cases were exposed to other tyrosine kinase inhibitors at the time of PH diagnosis. Clinical, functional, or hemodynamic improvements were observed within 4 months of dasatinib discontinuation in all but 1 patient. Three patients required PH treatment with endothelin receptor antagonist (n=2) or calcium channel blocker (n=1). After a median follow-up of 9 months (min-max 3-36), the majority of patients did not demonstrate complete clinical and hemodynamic recovery, and no patients reached a normal value of mean pulmonary artery pressure (≤20 mm Hg). Two patients (22%) died at follow-up (1 of unexplained sudden death and 1 of cardiac failure in the context of septicemia, respectively, 8 and 12 months after dasatinib withdrawal). The lowest estimate of incident PH occurring in patients exposed to dasatinib in France was 0.45%. CONCLUSIONS: Dasatinib may induce severe precapillary PH fulfilling the criteria of pulmonary arterial hypertension, thus suggesting a direct and specific effect of dasatinib on pulmonary vessels. Improvement is usually observed after withdrawal of dasatinib.
Sciences du Vivant/Biochimie, Biologie Moléculaire
Anglais
0009-7322

Articles dans des revues avec comité de lecture
10.1161/CIRCULATIONAHA.111.079921
Circulation (Circulation)
Publisher American Heart Association
ISSN 0009-7322 (eISSN : 1524-4539)
internationale
01/05/2012
26/03/2012
125
17
2128-37

adverse drug events – pulmonary hypertension – vascular complications – chronic myeloid leukemia dasatinib