Meta-Analysis of Randomized Controlled Trials on the Treatment of Pulmonary Arterial Hypertension

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  • He Bing
    Department of Pediatrics, Renmin Hospital of Wuhan University
  • Zhang Fengwen
    Department of Pediatrics, Peking University First Hospital
  • Li Xueying
    Department of Statistics, Peking University First Hospital
  • Tang Chaoshu
    Department of Physiology and Pathophysiology, Peking University Health Sciences Center Key Laboratory of Molecular Cardiology, Ministry of Education
  • Lin Guosheng
    Department of Cardiology, Renmin Hospital of Wuhan University
  • Du Junbao
    Department of Pediatrics, Peking University First Hospital
  • Jin Hongfang
    Department of Pediatrics, Peking University First Hospital

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タイトル別名
  • Meta-Analysis of Randomized Controlled Trials on Treatment of Pulmonary Arterial Hypertension

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Background: The aim of the present meta-analysis was to evaluate the efficacy and safety of treating pulmonary arterial hypertension (PAH) with inhaled iloprost, oral bosentan and sildenafil. Methods and Results: The randomized controlled trials on the 3 drugs and placebo were retrieved from the databases MEDLINE, EMBASE, BIOSIS Previews and CNKI up to August 2009. In total 11 studies and 1,391 patients were selected. Compared with placebo, iloprost, bosentan and sildenafil reduced clinical worsening significantly (odds ratio [OR] =0.33, 95% confidence interval [CI] =0.22-0.49, P<0.00001), improved New York Heart Association/World Health Organization functional class (OR =2.81, 95%CI =1.95-4.03, P<0.00001), increased the 6-min walk test by 33.19 m, reduced systolic pulmonary arterial pressure, mean pulmonary arterial pressure and pulmonary vascular resistance, increased the cardiac index by 0.40 L · min-1 · m-2 and increased the cardiac output by 0.53 L/min. The incidence of serious adverse events was similar in the medication groups and the placebo group (OR =1.09, 95%CI =0.69-1.71, P=0.72). In terms of the clinical worsening and functional class amelioration, insignificant differences were found among iloprost, bosentan and sildenafil, but iloprost had the highest incidence of serious adverse events among the 3 drugs. Conclusions: Inhaled iloprost and oral bosentan and sildenafil are effective and safe in treating PAH.  (Circ J 2010; 74: 74: 1458 - 1464)<br>

収録刊行物

  • Circulation Journal

    Circulation Journal 74 (7), 1458-1464, 2010

    一般社団法人 日本循環器学会

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