There is one clinical trial.
Pulmonary Arterial Hypertension (PAH) is a rare condition in which a narrowing of blood vessels carrying blood through the lungs puts an increased work load on the heart; it has to work harder to pump blood through the lungs. While current treatments relieve some of the symptoms, they do not stop or reverse the disease in the affected blood vessels. Imatinib is a medicine licensed for some types of cancers. A published study has shown that imatinib can have beneficial effects on blood flow through the lungs and exercise capacity in patients with PAH, even when added to existing treatments. However, there have been concerns about its safety and tolerability. Imatinib continues to be prescribed occasionally on compassionate grounds, usually when other treatment options have been exhausted, and some patients feel better on the drug. To improve the investigator's understanding, the investigators of this study re-visits the use of Imatinib as a potential treatment for patients with PAH.
Change in plasma proteome from baseline at 24 weeks.. Inclusion Criteria: 1. Subjects aged between 18-75 years old 2. PAH which is idiopathic, heritable or associated with anorexigens 3. Subjects homozygous at rs3816018 locus (PDGFRB genotype) 4. Resting mean pulmonary artery pressure >25 mmHg, Pulmonary capillary wedge pressure ≤15 mmHg, PVR >5 wood units, and normal or reduced cardiac output , as measured by right heart catheterisation (RHC) at entry 5. Six-minute walking distance >50m at entry 6. Stable on an unchanged PAH therapeutic regime comprising at least 2 therapies licensed for PAH (any combination of endothelin receptor antagonist, phosphodiesterase inhibitor or prostacyclin analogue) for at least 1 month prior to screening 7. Able to provide written informed consent prior to any study mandated procedures 8. Women of child-bearing potential are eligible to participate, if they agree to use one of the following contraception methods: Abstinence OR Highly effective contraceptive methods with typical-use failure rate <1% i.e. - Male or female sterilisation and long-acting reversible contraceptive methods (intrauterine devices and implants)prior to the female subject's entry into the study - Progestogen-only injections if repeat rejections are documented as having been administered on schedule by a healthcare professional.
Patients who have received an Investigational Medicinal Product (IMP) within 1 month before the baseline visit Inclusion Criteria: 1. Subjects aged between 18-75 years old 2. PAH which is idiopathic, heritable or associated with anorexigens 3. Subjects homozygous at rs3816018 locus (PDGFRB genotype) 4. Resting mean pulmonary artery pressure >25 mmHg, Pulmonary capillary wedge pressure ≤15 mmHg, PVR >5 wood units, and normal or reduced cardiac output , as measured by right heart catheterisation (RHC) at entry 5. Six-minute walking distance >50m at entry 6. Stable on an unchanged PAH therapeutic regime comprising at least 2 therapies licensed for PAH (any combination of endothelin receptor antagonist, phosphodiesterase inhibitor or prostacyclin analogue) for at least 1 month prior to screening 7. Able to provide written informed consent prior to any study mandated procedures 8. Women of child-bearing potential are eligible to participate, if they agree to use one of the following contraception methods: Abstinence OR Highly effective contraceptive methods with typical-use failure rate <1% i.e. - Male or female sterilisation and long-acting reversible contraceptive methods (intrauterine devices and implants)prior to the female subject's entry into the study - Progestogen-only injections if repeat rejections are documented as having been administered on schedule by a healthcare professional.
Description: Part 1: Discontinuation of the drug for more than 5 consecutive days due to Grade 2 or above Adverse Events, defined by NCI criteria (version 5.0, 2017) adapted for the study.
Measure: Identifying the Maximum tolerated dose Time: 12 monthsDescription: Part 2: The primary efficacy endpoint is a binary variable. For patients with a baseline pulmonary vascular resistance (PVR) >1000 dynes·s·cm−5, success is defined by an absolute reduction in PVR of ≥300 dynes·s·cm−5 at 24 weeks. For patients with a baseline PVR ≤1000 dynes·s·cm−5, success is a 30% reduction in PVR at 24 weeks.
Measure: Change in pulmonary vascular resistance (PVR) Time: 24 monthsDescription: Change in six minute walk distance (6MWD) at 24 weeks.
Measure: Change in exercise test Time: 24 weeksDescription: Change in right ventricular ejection fraction (RVEF) values, measured in echocardiogram (at screening visit and at 24 weeks).
Measure: Change in ejection fraction measures Time: 24 weeksDescription: Change in plasma BNP (or proNT-BNP) levels from baseline at 24 weeks.
Measure: Change in brain natriuretic peptide (BNP) values Time: 24 weeksDescription: Change in Quality of Life (QoL) scores from baseline at 24 weeks.
Measure: Change in quality of life scores Time: 24 weeksDescription: Change in plasma proteome from baseline at 24 weeks.
Measure: Plasma proteome measures Time: 24 weeks