Evidence synthesis in pulmonary arterial hypertension: a systematic review and critical appraisal

摘要: The clinical landscape of pulmonary arterial hypertension (PAH) has evolved in terms disease definition and classification, trial designs, available therapies treatment strategies as well guidelines. This study critically appraises published evidence synthesis studies, i.e. meta-analyses (MA) network-meta-analyses (NMA), to better understand their quality, validity discuss the impact findings from these studies on current decision-making PAH. A systematic literature review identify MA/NMA considering approved for PAH was conducted. Embase, Medline Cochrane’s Database Systematic Reviews were searched database inception April 22, 2020, supplemented by searches health technology assessment websites. International Society Pharmacoeconomics Outcomes Research (ISPOR) checklist covering six domains (relevance, credibility, analysis, reporting quality transparency, interpretation conflict interest) selected appraisal included studies. Fifty-two full publications (36 MAs, 15 NMAs, 1 MA/NMA) met inclusion criteria. majority low with none being scored ‘strong’ across all domains. Key limitations lack a clearly defined, relevant decision problem, shortcomings assessing addressing between-study heterogeneity, an incomplete or misleading results. is first critical PAH, suggesting this therapeutic area. Besides need direct comparisons assessed long-term randomized controlled trials, future efforts should improve analysis scrutiny order meaningfully address challenges arising evolving landscape.