The Clinical Efficacy of Pulmonary Hypertension-Specific Agents in Idiopathic Pulmonary Fibrosis: Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials
Journal of Korean Medical Science
; : 48-2020.
Article
em En
| WPRIM
| ID: wpr-810964
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND: Pulmonary hypertension (PH) is common in patients with idiopathic pulmonary fibrosis (IPF) and is associated with poor outcomes. This study was performed to determine the clinical efficacy of PH-specific therapeutic agents for IPF patients.METHODS: We performed a systematic review and meta-analysis using MEDLINE, EMBASE, and the Cochrane Central Register. We searched randomized controlled trials (RCTs) without language restriction until November 2018. The primary outcome was all-cause mortality to end of study.RESULTS: We analyzed 10 RCTs involving 2,124 patients, 1,274 of whom received PH-specific agents. In pooled estimates, the use of PH-specific agents was not significantly associated with reduced all-cause mortality to end of study compared with controls (hazard ratio, 0.99; 95% confidence interval [CI], 0.92, 1.06; P = 0.71; I² = 30%). When we performed subgroup analyses according to the type of PH-specific agent, sample size, age, forced vital capacity, diffusion lung capacity, and the extent of honeycombing, PH-specific agents also showed no significant association with a reduction in all-cause mortality. A small but significant improvement in quality of life, measured using the St. George Respiratory Questionnaire total score, was found in the PH-specific agent group (mean difference, −3.16 points; 95% CI, −5.34, −0.97; P = 0.005; I² = 0%). We found no significant changes from baseline in lung function, dyspnea, or exercise capacity. Serious adverse events were similar between the two groups.CONCLUSION: Although PH-specific agents provided small health-related quality-of-life benefits, our meta-analysis provides insufficient evidence to support their use in IPF patients.
Palavras-chave
Texto completo:
1
Base de dados:
WPRIM
Assunto principal:
Qualidade de Vida
/
Vasodilatadores
/
Capacidade Vital
/
Mortalidade
/
Resultado do Tratamento
/
Tamanho da Amostra
/
Difusão
/
Dispneia
/
Fibrose Pulmonar Idiopática
/
Hipertensão Pulmonar
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
/
Systematic_reviews
Aspecto:
Patient_preference
Limite:
Humans
Idioma:
En
Revista:
Journal of Korean Medical Science
Ano de publicação:
2020
Tipo de documento:
Article