Academic Journal
Medications for the treatment of pulmonary arterial hypertension: a systematic review and network meta-analysis
| العنوان: | Medications for the treatment of pulmonary arterial hypertension: a systematic review and network meta-analysis |
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| المؤلفون: | Tyler Pitre, Johnny Su, Sonya Cui, Ryan Scanlan, Christopher Chiang, Renata Husnudinov, Muhammad Faran Khalid, Nadia Khan, Gareth Leung, David Mikhail, Pakeezah Saadat, Shaneela Shahid, Jasmine Mah, Lisa Mielniczuk, Dena Zeraatkar, Sanjay Mehta |
| المصدر: | European Respiratory Review, Vol 31, Iss 165 (2022) |
| بيانات النشر: | European Respiratory Society, 2022. |
| سنة النشر: | 2022 |
| المجموعة: | LCC:Diseases of the respiratory system |
| مصطلحات موضوعية: | Diseases of the respiratory system, RC705-779 |
| الوصف: | Background: There is no consensus on the most effective treatments of pulmonary arterial hypertension (PAH). Our objective was to compare effects of medications for PAH. Methods: We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and Clinicaltrials.gov from inception to December 2021. We performed a frequentist random-effects network meta-analysis on all included trials. We rated the certainty of the evidence using the Grades of Recommendation, Assessment, Development, and Evaluation approach. Results: We included 53 randomised controlled trials with 10 670 patients. Combination therapy with endothelin receptor antagonist (ERA) plus phosphodiesterase-5 inhibitors (PDE5i) reduced clinical worsening (120.7 fewer events per 1000, 95% CI 136.8–93.4 fewer; high certainty) and was superior to either ERA or PDE5i alone, both of which reduced clinical worsening, as did riociguat monotherapy (all high certainty). PDE5i (24.9 fewer deaths per 1000, 95% CI 35.2 fewer to 2.1 more); intravenous/subcutaneous prostanoids (18.3 fewer deaths per 1000, 95% CI 28.6 fewer deaths to 0) and riociguat (29.1 fewer deaths per 1000, 95% CI 38.6 fewer to 8.7 more) probably reduce mortality as compared to placebo (all moderate certainty). Combination therapy with ERA+PDE5i (49.9 m, 95% CI 25.9–73.8 m) and riociguat (49.5 m, 95% CI 17.3–81.7 m) probably increase 6-min walk distance as compared to placebo (moderate certainty). Conclusion: Current PAH treatments improve clinically important outcomes, although the degree and certainty of benefit vary between treatments. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 0905-9180 1600-0617 16000617 |
| Relation: | http://err.ersjournals.com/content/31/165/220036.full; https://doaj.org/toc/0905-9180; https://doaj.org/toc/1600-0617 |
| DOI: | 10.1183/16000617.0036-2022 |
| URL الوصول: | https://doaj.org/article/9451fee729d64f16bebbe819587d0278 |
| رقم الانضمام: | edsdoj.9451fee729d64f16bebbe819587d0278 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 09059180 16000617 |
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| DOI: | 10.1183/16000617.0036-2022 |