Efficacy and safety of selexipag, an oral prostacyclin receptor agonist for the treatment of pulmonary hypertension: A meta-analysis

2021 ◽  
pp. 102100
Author(s):  
Minshan Chen ◽  
Yuanqiang Lai ◽  
Riken Chen ◽  
Jianmin Lu ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Receptor Agonist ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Prostacyclin Receptor

Safety and Efficacy of Eltrombopag in Children and Adults with Immune Thrombocytopenia: a Systematic Review and Meta-analysis.

2020 ◽  
Vol 18 ◽  
Author(s):  
Savvas Kolanis ◽  
Eleni Vasileiou ◽  
Emmanuel Hatzipantelis ◽  
Marina Economou ◽  
Athanasios Tragiannidis
Keyword(s):  
Receptor Agonist ◽  
Immune Thrombocytopenia ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Primary Target ◽  
Rescue Treatment ◽  
Thrombopoietin Receptor ◽  
Number Of Patients ◽  
Thrombopoietin Receptor Agonist ◽  
Adults And Children

: Immune thrombocytopenia is an immune condition where antibodies are produced against platelets. Eltrombopag is a thrombopoietin receptor agonist that stimulates and promotes platelet production approved for treating thrombocytopenia in patients with chronic immune thrombocytopenia, where other treatments as corticosteroids, splenectomy or immunoglobulins are inadequate. The aim of this meta-analysis was to evaluate the efficacy and safety of the eltrombopag in adults and children with immune thrombocytopenia. We included 7 studies with a total of 765 patients (606 adults and 159 children). We evaluated the number of patients that achieved a post treatment platelet count equal or above 50x109 /L (primary result-target) without the need of rescue treatment for at least 4 weeks. Our data showed that patients who received eltrombopag were almost 4 times more probable in achieving the primary target when compared to patients that received placebo (RR 3.84, 95% CI 2.39 to 6.14; I2 = 46%). The number of patients that needed rescue treatment and the number of bleeding incidents were reduced in the group that received eltrombopag when compared to those who received placebo (RR 0.40, 95% CI 0.25 to 0.62; I2 = 40%) (RR 0.74, 95% CI 0.62 to 0.89; I2 = 68%). The total number of side effects did not statistically differ between the two groups (RR 0.99, 95% CI 0.90 to 1.08; I2 = 14%). Our findings were similar to previously published studies and confirm that eltrombopag is safe and efficient in immune thrombocytopenia. However more clinical trials are needed in order to enhance our findings.

scholarly journals The Efficacy and Safety of Pulmonary Vasodilators in Pediatric Pulmonary Hypertension (PH): A Systematic Review and Meta-analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Tingting Shu ◽  
Huaqiao Chen ◽  
Lu Wang ◽  
Wuwan Wang ◽  
Panpan Feng ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Pulmonary Hypertension ◽  
Meta Analysis ◽  
Control Group ◽  
Efficacy And Safety ◽  
Pulmonary Vasodilators ◽  
Ventilation Duration ◽  
Mechanical Ventilation Duration ◽  
Pulmonary Arterial

Background: We performed a meta-analysis to evaluate the efficacy and safety of pulmonary vasodilators in pediatric pulmonary hypertension (PH) patients.Methods: We searched electronic databases including PubMed, EMBASE, and the Cochrane Library up to May 2020, and conducted a subgroup analysis for pulmonary vasodilators or underlying disease.Results: Fifteen studies with 719 pediatric PH patients were included in the meta-analysis. Adverse events did not differ (p = 0.11, I2 = 15%) between the pulmonary vasodilators group and the control group, neither in the subgroups. In total, compared with the control group treatment, pulmonary vasodilators significantly decreased the mortality (p = 0.002), mean pulmonary artery pressure (mPAP, p = 0.02), and mechanical ventilation duration (p = 0.03), also improved the oxygenation index (OI, p = 0.01). In the persistent pulmonary hypertension of the newborn (PPHN) subgroup, phosphodiesterase type 5 inhibitors (PDE5i) significantly reduced mortality (p = 0.03), OI (p = 0.007) and mechanical ventilation duration (p = 0.004). Administration of endothelin receptor antagonists (ERAs) improved OI (p = 0.04) and mechanical ventilation duration (p < 0.00001) in PPHN. We also found that in the pediatric pulmonary arterial hypertension (PPAH) subgroup, mPAP was pronouncedly declined with ERAs (p = 0.006). Systolic pulmonary artery pressure (sPAP, p < 0.0001) and pulmonary arterial/aortic pressure (PA/AO, p < 0.00001) were significantly relieved with PDE5i, partial pressure of arterial oxygen (PaO2) was improved with prostacyclin in postoperative PH (POPH) subgroup (p = 0.001). Compared with the control group, pulmonary vasodilators could significantly decrease PA/AO pressure (p < 0.00001) and OI (p < 0.00001) in the short-term (duration <7 days) follow-up subgroup, improve mPAP (p = 0.03) and PaO2 (p = 0.01) in the mid-term (7–30 days) follow-up subgroup, also decrease mortality, mPAP (p = 0.0001), PA/AO pressure (p = 0.0007), duration of mechanical ventilation (p = 0.004), and ICU stay (p < 0.00001) in the long-term follow subgroup (>30 days).Conclusion: Pulmonary vasodilators decrease the mortality in pediatric PH patients, improve the respiratory and hemodynamic parameters, reduce the mechanical ventilation duration.

Efficacy and Safety of Statins for Pulmonary Hypertension: A Meta-Analysis of Randomised Controlled Trials

2017 ◽  
Vol 26 (5) ◽  
pp. 425-432 ◽  
Author(s):  
Yitao Zhang ◽  
Weijie Zeng ◽  
Shiyao Cheng ◽  
Zhichong Chen ◽  
Jiaojie Xue ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomised Controlled

scholarly journals Clinical Efficacy and Safety of Different Doses of Sildenafil in the Treatment of Persistent Pulmonary Hypertension of the Newborn: A Network Meta-analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Linli Sun ◽  
Chunxia Wang ◽  
Yulu Zhou ◽  
Wei Sun ◽  
Chunjiang Wang
Keyword(s):  
Pulmonary Hypertension ◽  
Partial Pressure ◽  
Clinical Efficacy ◽  
Meta Analysis ◽  
Arterial Oxygen Saturation ◽  
Persistent Pulmonary Hypertension ◽  
Arterial Oxygen ◽  
Efficacy And Safety ◽  
Different Doses ◽  
Better Than

Objective: To evaluate the efficacy and safety of different doses of sildenafil for persistent pulmonary hypertension of the newborn (PPHN) with Bayesian random effects network meta-analysis.Methods: We searched Chinese and English databases for randomized controlled trials (RCTs) concerning sildenafil in newborns with persistent pulmonary hypertension from 1998 to December 2020.Results: Twenty-two RCTs including over 2131 patients were included. Sildenafil was administered by nasal feeding at 0.3–2 mg/kg every 4–6 h. The network meta-analysis revealed that 1.5 mg/kg of sildenafil led to a significant decrease in pulmonary artery systolic pressure (PASP) compared with 0.3 and 0.6 mg/kg (p < 0.05); 1.5 mg/kg was better than 0.3, 0.5, and 1.0 mg/kg at increasing the partial pressure of oxygen (PaO2) (p < 0.05); 1.5 mg/kg was better than 0.5, 0.6 and 1.0 mg/kg at reducing the partial pressure of carbon dioxide (PaCO2) (p < 0.05); and 1.2 mg/kg was better than 0.3, 0.5 and 1.0 mg/kg at increasing the arterial oxygen saturation (SaO2) (p < 0.05). The surface under the cumulative ranking analysis (SUCRA) results showed that 1.5 mg/kg had the best effect in reducing PASP (SUCRA = 92.0%, moderate certainty evidence) and PaCO2 (91.1%) and increasing PaO2 (SUCRA = 79.3%, moderate certainty evidence), 2.0 mg/kg had the best effect in increasing SaO2 (SUCRA = 88.6%, moderate certainty evidence) and total effective rate (SUCRA = 93.5%, low certainty of evidence)). No severe adverse effects were observed with the different doses of sildenafil.Conclusion: Different doses of sildenafil can significantly improve PPHN, and 1.5 mg/kg of sildenafil has better clinical efficacy and does not increase the probability of adverse reactions.

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