Meta-analysis of randomized controlled trials of bosentan for treatment of pulmonary arterial hypertension

被引:14
|
作者
Lee, Young Ho
Song, Gwan Gyu
机构
[1] Division of Rheumatology, Department of Internal Medicine, Korea University College of Medicine, Seoul
来源
KOREAN JOURNAL OF INTERNAL MEDICINE | 2013年 / 28卷 / 06期
关键词
RECEPTOR ANTAGONIST BOSENTAN; DOUBLE-BLIND; BLOCKERS; THERAPY;
D O I
10.3904/kjim.2013.28.6.701
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background/Aims: We assessed the efficacy and safety of bosentan. in. patients with pulmonary arterial hypertension (PAH). Methods: We surveyed randomized controlled trials (RCTs) of the efficacy and safety of bosentan. in patients with PAH using MEDLINE, EMBASE, the Cochrane Controlled Trials Register, and manual searches. Meta-analysis of RCTs was performed to determine treatment efficacy and safety outcomes. Results are presented as odds ratios (ORs) or weighted mean differences (WMDs). Results: Meta-analysis of seven RCTs including a total of 410 patients and 296 controls revealed that the 6-minute work distance was significantly higher in the bosentan group than in the placebo group (WMD, 46.19; 95% confidence interval [CI], 21.20 to 71.19; p = 2.9 x 10(-5)). Compared with the placebo, bosentan significantly reduced the mean pulmonary arterial pressure in patients with PAH (WMD, -6.026; 95% CI, -8.785 to -3.268, p = 1.8 x 10(-6)). The bosentan therapy group worsened less clinically than. the placebo group (OR, 0.252; 95% CI, 0.140 to 0.454; p 4.6 x 10(-7)). The incidence of serious adverse events did not differ between the bosentan and placebo groups (OR, 0.948; 95% CI, 0.556 to 1.614; p = 0.843). However, the results of the abnormal liver function test (LFT) were significantly higher in the bosentan. group than. in the placebo group (OR, 2.312; 95% CI, 1.020 to 5.241; p 0.045). Conclusions: This meta-analysis shows that bosentan can treat PAH effectively. However, bosentan increased the incidence of abnormal LFT results compared with the placebo.
引用
收藏
页码:701 / 707
页数:7
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