MedPage Today, "'Wonder Drugs' May Work Wonders for Pulmonary Arterial Hypertension"

          The "wonder drugs" Gleevec (imatinib) and Viagra (sildenafil) make strange bedfellows, but they both appear to improve pulmonary function in patients with pulmonary arterial hypertension (PAH), report researchers here. They described the Gleevec case in a letter published in the Sept. 29 New England Journal of Medicine.
          In a last-ditch attempt to save a 61 year-old man with severe, familial idiopathic PAH that was rapidly progressing despite other therapies, Friedrich Grimminger, M.D., Ph.D., and colleagues at the University Hospital Giessen here gave him oral Gleevec (imatinib) 200 mg daily on a compassionate basis.
         Gleevec, which is approved for chronic myeloid leukemia, has potent antiproliferative properties that the researchers hypothesized might be able to reverse the lung vascular remodeling -- uncontrolled proliferation of the vascular wall -- that is the underlying pathogenic mechanism of PAH.  In contrast, Viagra (sildenafil), which has also been shown to improve function in patients with PAH, works by prolonged vasodilation, allowing better oxygenation.