Efficacy and Safety of Treating Pulmonary Arterial Hypertension With Imatinib: A Meta-Analysis of Randomized Controlled Trials

Abstract

Pulmonary vascular remodeling and arterial hypertension (PAH) correlate with increased platelet-derived growth factor activity and elevated KIT expression. Imatinib has emerged as a potential therapeutic agent for PAH. The purpose of this systematic review and meta-analysis was to assess the effectiveness of imatinib in the treatment of PAH. A literature search was conducted with the PubMed, Embase, Web of Science, and Cochrane Library to obtain randomized controlled trials where the efficacy of imatinib and placebo in patients with PAH was compared. Three randomized controlled trials that involved 262 patients were finally included in this study. Results showed that imatinib significantly improved 6-minute walk distance (mean difference [MD] = 42.76, 95% confidence interval [CI], 9.20-76.32, P = 0.01), reduced pulmonary vascular resistance (MD = -396.68, 95% CI, -474.50 to -318.85, P < 0.00001), and lowered mean pulmonary arterial pressure (MD = -7.29, 95% CI, -13.97 to -0.61, P = 0.03) in patients with PAH. No significant difference was found between the imatinib and placebo groups in terms of mortality (odds ratio = 1.25, 95% CI, 0.49-3.18) or adverse events (odds ratio = 1.82, 95% CI, 0.76-4.36, P = 0.18). Despite the significant improvement of key hemodynamic parameters, there was no advantage in reducing clinical adverse events or mortality. The prolonged efficacy and safety of imatinib in patients with PAH warrant further studies.