Efficacy and tolerability of pharmacological interventions for pulmonary arterial hypertension: A network meta-analysis

摘要: Abstract Purpose This network meta-analysis (NMA) is designed to compare the efficacy and tolerability of various therapies combinations for pulmonary arterial hypertension (PAH). Method We conducted a systematic search in databases PubMed, Embase, Cochrane Library. Treatment were compared by synthesizing direct indirect evidence. The surface under curve ranking area was utilized rank multiple interventions. Result A total 43 randomized clinical trials included our NMA. With regard outcomes, including 6 min walking distance (6MWD), functional class amelioration (FCA), death, worsening (CW), vascular resistance (PVR), mean artery pressure (mPAP), cardiac index (CI), right atrial (mRAP), endothelin receptor antagonists (ERA), phosphodiesterase 5 inhibitor (PDE-5Is), ERA combined with PDE-5Is (EAP), prostacyclin analogs (PGI) (PAE) performed better than others. Meanwhile PAP PGE demonstrated others tolerability. Overall, EAP PAE showed good well-tolerated among all therapies. Conclusion we recommend as optimal choice patients PAH practice suboptimal view their desirable performance efficacy. Most combination monotherapies.