Cargando…
A meta-analysis of the safety and efficacy of bosentan therapy combined with prostacyclin analogues or phosphodiesterase type-5 inhibitors for pulmonary arterial hypertension
Bosentan is an effective drug for the treatment of pulmonary arterial hypertension (PAH). The aim of the present meta-analysis was to examine the evidence concerning the efficacy and safety of bosentan therapy combined with prostacyclin analogues or phosphodiesterase type 5 (PDE-5) inhibitors for tr...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
D.A. Spandidos
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6878909/ https://www.ncbi.nlm.nih.gov/pubmed/31798703 http://dx.doi.org/10.3892/etm.2019.8142 |
_version_ | 1783473531941552128 |
---|---|
author | Dang, Zhan-Cui Tang, Bo Li, Bin Liu, Shou Ge, Ri-Li Li, Zhan-Qiang Lu, Dian-Xiang |
author_facet | Dang, Zhan-Cui Tang, Bo Li, Bin Liu, Shou Ge, Ri-Li Li, Zhan-Qiang Lu, Dian-Xiang |
author_sort | Dang, Zhan-Cui |
collection | PubMed |
description | Bosentan is an effective drug for the treatment of pulmonary arterial hypertension (PAH). The aim of the present meta-analysis was to examine the evidence concerning the efficacy and safety of bosentan therapy combined with prostacyclin analogues or phosphodiesterase type 5 (PDE-5) inhibitors for treating PAH. Eligible published studies were collected from Embase, PubMed, The Cochrane Library and the www.clinicaltrials.gov website. Heterogeneity was assessed using the Cochran Q-statistic test. Results were presented as risk ratios or mean differences with 95% confidence intervals (CI). A total of five studies, comprising 310 patients were included for analysis. No significant improvements in six-minute walk distance (6MWD; mean difference, 16.43 m), clinical worsening (risk ratio, 0.54) and the World Health Organization functional classification (class I: risk ratio, 1.17; class II: risk ratio, 1.18) were observed in patients treated with bosentan in combination with prostacyclin analogues or PDE-5 inhibitors. However, a significant reduction in the mean pulmonary artery pressure (mPAP; 95% CI: −17.06, −6.83; P<0.0001) following bosentan combination therapy was observed. Comparisons of adverse event rates in the bosentan combination therapy (55.6%) and monotherapy (51.8%) suggested that there is no reduction in adverse events (risk ratio, 1.10). The results indicated that bosentan combined with prostacyclin analogues or PDE-5 inhibitors may not improve 6MWD, cardiac function, clinical worsening and adverse events. However, bosentan combined with prostacyclin analogues or PDE-5 inhibitor therapy was able to significantly reduce mPAP compared with the effect of bosentan monotherapy. |
format | Online Article Text |
id | pubmed-6878909 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | D.A. Spandidos |
record_format | MEDLINE/PubMed |
spelling | pubmed-68789092019-12-03 A meta-analysis of the safety and efficacy of bosentan therapy combined with prostacyclin analogues or phosphodiesterase type-5 inhibitors for pulmonary arterial hypertension Dang, Zhan-Cui Tang, Bo Li, Bin Liu, Shou Ge, Ri-Li Li, Zhan-Qiang Lu, Dian-Xiang Exp Ther Med Articles Bosentan is an effective drug for the treatment of pulmonary arterial hypertension (PAH). The aim of the present meta-analysis was to examine the evidence concerning the efficacy and safety of bosentan therapy combined with prostacyclin analogues or phosphodiesterase type 5 (PDE-5) inhibitors for treating PAH. Eligible published studies were collected from Embase, PubMed, The Cochrane Library and the www.clinicaltrials.gov website. Heterogeneity was assessed using the Cochran Q-statistic test. Results were presented as risk ratios or mean differences with 95% confidence intervals (CI). A total of five studies, comprising 310 patients were included for analysis. No significant improvements in six-minute walk distance (6MWD; mean difference, 16.43 m), clinical worsening (risk ratio, 0.54) and the World Health Organization functional classification (class I: risk ratio, 1.17; class II: risk ratio, 1.18) were observed in patients treated with bosentan in combination with prostacyclin analogues or PDE-5 inhibitors. However, a significant reduction in the mean pulmonary artery pressure (mPAP; 95% CI: −17.06, −6.83; P<0.0001) following bosentan combination therapy was observed. Comparisons of adverse event rates in the bosentan combination therapy (55.6%) and monotherapy (51.8%) suggested that there is no reduction in adverse events (risk ratio, 1.10). The results indicated that bosentan combined with prostacyclin analogues or PDE-5 inhibitors may not improve 6MWD, cardiac function, clinical worsening and adverse events. However, bosentan combined with prostacyclin analogues or PDE-5 inhibitor therapy was able to significantly reduce mPAP compared with the effect of bosentan monotherapy. D.A. Spandidos 2019-12 2019-10-29 /pmc/articles/PMC6878909/ /pubmed/31798703 http://dx.doi.org/10.3892/etm.2019.8142 Text en Copyright: © Dang et al. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
spellingShingle | Articles Dang, Zhan-Cui Tang, Bo Li, Bin Liu, Shou Ge, Ri-Li Li, Zhan-Qiang Lu, Dian-Xiang A meta-analysis of the safety and efficacy of bosentan therapy combined with prostacyclin analogues or phosphodiesterase type-5 inhibitors for pulmonary arterial hypertension |
title | A meta-analysis of the safety and efficacy of bosentan therapy combined with prostacyclin analogues or phosphodiesterase type-5 inhibitors for pulmonary arterial hypertension |
title_full | A meta-analysis of the safety and efficacy of bosentan therapy combined with prostacyclin analogues or phosphodiesterase type-5 inhibitors for pulmonary arterial hypertension |
title_fullStr | A meta-analysis of the safety and efficacy of bosentan therapy combined with prostacyclin analogues or phosphodiesterase type-5 inhibitors for pulmonary arterial hypertension |
title_full_unstemmed | A meta-analysis of the safety and efficacy of bosentan therapy combined with prostacyclin analogues or phosphodiesterase type-5 inhibitors for pulmonary arterial hypertension |
title_short | A meta-analysis of the safety and efficacy of bosentan therapy combined with prostacyclin analogues or phosphodiesterase type-5 inhibitors for pulmonary arterial hypertension |
title_sort | meta-analysis of the safety and efficacy of bosentan therapy combined with prostacyclin analogues or phosphodiesterase type-5 inhibitors for pulmonary arterial hypertension |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6878909/ https://www.ncbi.nlm.nih.gov/pubmed/31798703 http://dx.doi.org/10.3892/etm.2019.8142 |
work_keys_str_mv | AT dangzhancui ametaanalysisofthesafetyandefficacyofbosentantherapycombinedwithprostacyclinanaloguesorphosphodiesterasetype5inhibitorsforpulmonaryarterialhypertension AT tangbo ametaanalysisofthesafetyandefficacyofbosentantherapycombinedwithprostacyclinanaloguesorphosphodiesterasetype5inhibitorsforpulmonaryarterialhypertension AT libin ametaanalysisofthesafetyandefficacyofbosentantherapycombinedwithprostacyclinanaloguesorphosphodiesterasetype5inhibitorsforpulmonaryarterialhypertension AT liushou ametaanalysisofthesafetyandefficacyofbosentantherapycombinedwithprostacyclinanaloguesorphosphodiesterasetype5inhibitorsforpulmonaryarterialhypertension AT gerili ametaanalysisofthesafetyandefficacyofbosentantherapycombinedwithprostacyclinanaloguesorphosphodiesterasetype5inhibitorsforpulmonaryarterialhypertension AT lizhanqiang ametaanalysisofthesafetyandefficacyofbosentantherapycombinedwithprostacyclinanaloguesorphosphodiesterasetype5inhibitorsforpulmonaryarterialhypertension AT ludianxiang ametaanalysisofthesafetyandefficacyofbosentantherapycombinedwithprostacyclinanaloguesorphosphodiesterasetype5inhibitorsforpulmonaryarterialhypertension AT dangzhancui metaanalysisofthesafetyandefficacyofbosentantherapycombinedwithprostacyclinanaloguesorphosphodiesterasetype5inhibitorsforpulmonaryarterialhypertension AT tangbo metaanalysisofthesafetyandefficacyofbosentantherapycombinedwithprostacyclinanaloguesorphosphodiesterasetype5inhibitorsforpulmonaryarterialhypertension AT libin metaanalysisofthesafetyandefficacyofbosentantherapycombinedwithprostacyclinanaloguesorphosphodiesterasetype5inhibitorsforpulmonaryarterialhypertension AT liushou metaanalysisofthesafetyandefficacyofbosentantherapycombinedwithprostacyclinanaloguesorphosphodiesterasetype5inhibitorsforpulmonaryarterialhypertension AT gerili metaanalysisofthesafetyandefficacyofbosentantherapycombinedwithprostacyclinanaloguesorphosphodiesterasetype5inhibitorsforpulmonaryarterialhypertension AT lizhanqiang metaanalysisofthesafetyandefficacyofbosentantherapycombinedwithprostacyclinanaloguesorphosphodiesterasetype5inhibitorsforpulmonaryarterialhypertension AT ludianxiang metaanalysisofthesafetyandefficacyofbosentantherapycombinedwithprostacyclinanaloguesorphosphodiesterasetype5inhibitorsforpulmonaryarterialhypertension |