Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Pulmonary Circulation
Meta-Analysis of Randomized Controlled Trials on Treatment of Pulmonary Arterial Hypertension
Bing HeFengwen ZhangXueying LiChaoshu TangGuosheng LinJunbao DuHongfang Jin
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JOURNAL FREE ACCESS

2010 Volume 74 Issue 7 Pages 1458-1464

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Abstract

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)

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© 2010 THE JAPANESE CIRCULATION SOCIETY
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