PURPOSE: Bepridil inhibits the Na+, K +, and Ca 2+ channels in cardiomyocytes, and has antiarrhythmic effect by reducing the maximum depolarization rate of atrial muscle, atrioventricular node, ventricular muscle, and so on. Bepridil has been used for the treatment of atrial fibrillation, ventricular tachyarrhythmia and angina pectoris. There are several reported cases of bepridil-induced interstitial pneumonia, however, the incidence of bepridil-induced interstitial pneumonia is still unknown. The aim of the present study is to evaluate the incidence rate of bepridil-induced interstitial pneumonia.
METHODS: 270 patients with bepridil treatment between January 2009 and January 2011 were retrospectively evaluated in Saiseikai Yamaguchi General hospital. The incidence of bepridil-induced interstitial pneumonia in 214 patients with at least six months of bepridil treatment and chest X-ray and/or chest computed tomography films of pre- and post- bepridil treatment were analyzed with their clinical data by three specialized respirologists. The outcome and treatment of patients with bepridil-induced interstitial pneumonia were also evaluated.
RESULTS: The average (median) age of evaluated 214 patients were 74 (76) years old, and ratio of male/female was 153/61. Eight cases (male/female: 5/3, age ranged 64-97, average 80.5, median 81.0 years old) showed bepridil-induced interstitial pneumonia in 215 patients with bepridil treatment, and the incidence rate was 3.73%. The time to developing interstitial pneumonia after starting bepridil treatment ranged from 14 days to 10 months (average 152, median 195 days). Six cases received corticosteroid (starting dose of prednisolone 20-500 mg/day) with cessation of bepridil, and the treatment of the remaining two cases was only drug discontinuation. All 8 cases showed improvement of interstitial pneumonia after the treatment.
CONCLUSIONS: The incidence rate of bepridil-induced interstitial pneumonia was 3.73%, and all cases showed improvement of interstitial pneumonia after discontinuation of bepridil with or without corticosteroid treatment.
CLINICAL IMPLICATIONS: This is the first report of the incident rate and outcome of bepridil-induced interstitial pneumonia.
DISCLOSURE: The following authors have nothing to disclose: Kazuhiro Yatera, Kei Yamasaki, Shingo Noguchi, Hiroshi Ishimoto, Shiro Ono, Hiroshi Mukae
No Product/Research Disclosure Information