Meta-analysis of randomized controlled trials of bosentan for treatment of pulmonary arterial hypertension
The Korean Journal of Internal Medicine
;
: 701-707, 2013.
Article
in English
| WPRIM
| ID: wpr-157977
ABSTRACT
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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pulmonary Artery
/
Sulfonamides
/
Time Factors
/
Odds Ratio
/
Risk Factors
/
Treatment Outcome
/
Arterial Pressure
/
Hypertension, Pulmonary
/
Liver
/
Liver Function Tests
Type of study:
Controlled clinical trial
/
Etiology study
/
Practice guideline
/
Risk factors
/
Systematic reviews
Limits:
Humans
Language:
English
Journal:
The Korean Journal of Internal Medicine
Year:
2013
Type:
Article
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