Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học 'Respiratory Research cung cấp cho các bạn kiến thức về ngành y đề tài: Pharmacotherapy in pulmonary arterial hypertension: a systematic review and meta-analysis. | Ryerson et al. Respiratory Research 2010 11 12 http content 11 1 12 RESEARCH RESPIRATORY RESEARCH Open Access Pharmacotherapy in pulmonary arterial hypertension a systematic review and meta-analysis Christopher J Ryerson Shalini Nayar John R Swiston Don D Sin Abstract Background Previous meta-analyses of treatments for pulmonary arterial hypertension PAH have not shown mortality benefit from any individual class of medication. Methods MEDLINE EMBASE and the Cochrane Central Register of Controlled Trials were searched from inception through November 2009 for randomized trials that evaluated any pharmacotherapy in the treatment of PAH. Reference lists from included articles and recent review articles were also searched. Analysis included randomized placebo controlled trials of at least eight weeks duration and studies comparing intravenous medication to an unblinded control group. Results 1541 unique studies were identified and twenty-four articles with 3758 patients were included in the meta-analysis. Studies were reviewed and data extracted regarding study characteristics and outcomes. Data was pooled for three classes of medication prostanoids endothelin-receptor antagonists ERAs and phosphodiesterase type 5 PDE5 inhibitors. Pooled relative risks RRs and 95 confidence intervals CIs were calculated for mortality 6-minute walk distance dyspnea scores hemodynamic parameters and adverse effects. Mortality in the control arms was a combined over the mean study length of weeks. There was significant mortality benefit with prostanoid treatment RR CI to particularly comparing intravenous agents to control RR CI to . Mortality benefit was not observed for ERAs RR CI to or PDE5 inhibitors RR CI to . All three classes of medication improved other clinical and hemodynamic endpoints. Adverse effects that were increased in treatment arms include jaw pain diarrhea peripheral edema .
