PAH-specific therapy for pulmonary hypertension and interstitial lung disease: A systemic review and meta-analysis
ObjectivePulmonary hypertension (PH) in context with interstitial lung disease (ILD) portends serious clinical consequences and a high rate of mortality. Recently published randomized controlled trials (RCTs) which assessed the pulmonary arterial hypertension (PAH)-specific drugs for pulmonary hyper...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.992879/full |
| _version_ | 1811224493816807424 |
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| author | Ning Zhao Jun Chen Mingming Zhang Lihui Zhou Lisong Liu Jie Yuan Xingxue Pang Dayi Hu Xiaoxia Ren Zhongyi Jin |
| author_facet | Ning Zhao Jun Chen Mingming Zhang Lihui Zhou Lisong Liu Jie Yuan Xingxue Pang Dayi Hu Xiaoxia Ren Zhongyi Jin |
| author_sort | Ning Zhao |
| collection | DOAJ |
| description | ObjectivePulmonary hypertension (PH) in context with interstitial lung disease (ILD) portends serious clinical consequences and a high rate of mortality. Recently published randomized controlled trials (RCTs) which assessed the pulmonary arterial hypertension (PAH)-specific drugs for pulmonary hypertension and interstitial lung disease (PH-ILD) revealed inconsistent clinical outcomes with previous studies. We conducted a systemic review and meta-analysis to further investigate the effect of PAH-specific therapies for PH-ILD.MethodsClinical trials were searched from the EMBASE, PUBMED, and CENTRAL databases. The duration from the establishment of the database to June 2022 for RCTs evaluates the effect of PAH-specific therapy in patients with PH-ILD. RevMan 5.4 was used for the meta-analysis.ResultsA total of six articles (with a total of 791 patients) were included, including 412 patients in the treated group and 379 patients in the control group. As compared to placebo, the change of 6MWD was a significant improvement with PAH-specific therapy in the six RCTs (23.09; 95% CI, 12.07–34.12 P < 0.0001); but when the study with inhaled treprostinil was excluded, the significant improvement in the change of 6MWD from baseline was not present anymore (MD 11.01, 95%CI−6.43–28.46 P = 0.22). There was no significant improvement in the change in lung function, hemodynamic parameters, clinical worsening, all-cause death, and serious adverse effects in the treated group compared to placebo.ConclusionPAH-specific therapy significantly improved exercise capacity in the patients with PH-ILD, but this is due to the greater contribution of the study with inhaled treprostinil. Therefore, our findings still did not support the routine use of the whole PAH-specific drugs for PH-ILD. |
| first_indexed | 2024-04-12T08:50:30Z |
| format | Article |
| id | doaj.art-49c5fe4cdd8b4f8dba792ed2d3cc18d1 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-12T08:50:30Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-49c5fe4cdd8b4f8dba792ed2d3cc18d12022-12-22T03:39:35ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-11-01910.3389/fcvm.2022.992879992879PAH-specific therapy for pulmonary hypertension and interstitial lung disease: A systemic review and meta-analysisNing Zhao0Jun Chen1Mingming Zhang2Lihui Zhou3Lisong Liu4Jie Yuan5Xingxue Pang6Dayi Hu7Xiaoxia Ren8Zhongyi Jin9Department of Geriatrics, Chui Yang Liu Hospital Affiliated to Tsinghua University, Beijing, ChinaCapital Medical University, Beijing, ChinaDepartment of Cardiology, Chui Yang Liu Hospital Affiliated to Tsinghua University, Beijing, ChinaDepartment of Cardiology, Chui Yang Liu Hospital Affiliated to Tsinghua University, Beijing, ChinaCardiac Rehabilitation Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaDepartment of Cardiovascular Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaDepartment of Cardiovascular Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaDepartment of Cardiology, Peking University People's Hospital, Beijing, ChinaDepartment of Cardiovascular Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaDepartment of Cardiovascular Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaObjectivePulmonary hypertension (PH) in context with interstitial lung disease (ILD) portends serious clinical consequences and a high rate of mortality. Recently published randomized controlled trials (RCTs) which assessed the pulmonary arterial hypertension (PAH)-specific drugs for pulmonary hypertension and interstitial lung disease (PH-ILD) revealed inconsistent clinical outcomes with previous studies. We conducted a systemic review and meta-analysis to further investigate the effect of PAH-specific therapies for PH-ILD.MethodsClinical trials were searched from the EMBASE, PUBMED, and CENTRAL databases. The duration from the establishment of the database to June 2022 for RCTs evaluates the effect of PAH-specific therapy in patients with PH-ILD. RevMan 5.4 was used for the meta-analysis.ResultsA total of six articles (with a total of 791 patients) were included, including 412 patients in the treated group and 379 patients in the control group. As compared to placebo, the change of 6MWD was a significant improvement with PAH-specific therapy in the six RCTs (23.09; 95% CI, 12.07–34.12 P < 0.0001); but when the study with inhaled treprostinil was excluded, the significant improvement in the change of 6MWD from baseline was not present anymore (MD 11.01, 95%CI−6.43–28.46 P = 0.22). There was no significant improvement in the change in lung function, hemodynamic parameters, clinical worsening, all-cause death, and serious adverse effects in the treated group compared to placebo.ConclusionPAH-specific therapy significantly improved exercise capacity in the patients with PH-ILD, but this is due to the greater contribution of the study with inhaled treprostinil. Therefore, our findings still did not support the routine use of the whole PAH-specific drugs for PH-ILD.https://www.frontiersin.org/articles/10.3389/fcvm.2022.992879/fullpulmonary hypertensioninterstitial lung disease6-min walk distance (6MWD)treprostinilpulmonary arterial hypertension (PAH) |
| spellingShingle | Ning Zhao Jun Chen Mingming Zhang Lihui Zhou Lisong Liu Jie Yuan Xingxue Pang Dayi Hu Xiaoxia Ren Zhongyi Jin PAH-specific therapy for pulmonary hypertension and interstitial lung disease: A systemic review and meta-analysis Frontiers in Cardiovascular Medicine pulmonary hypertension interstitial lung disease 6-min walk distance (6MWD) treprostinil pulmonary arterial hypertension (PAH) |
| title | PAH-specific therapy for pulmonary hypertension and interstitial lung disease: A systemic review and meta-analysis |
| title_full | PAH-specific therapy for pulmonary hypertension and interstitial lung disease: A systemic review and meta-analysis |
| title_fullStr | PAH-specific therapy for pulmonary hypertension and interstitial lung disease: A systemic review and meta-analysis |
| title_full_unstemmed | PAH-specific therapy for pulmonary hypertension and interstitial lung disease: A systemic review and meta-analysis |
| title_short | PAH-specific therapy for pulmonary hypertension and interstitial lung disease: A systemic review and meta-analysis |
| title_sort | pah specific therapy for pulmonary hypertension and interstitial lung disease a systemic review and meta analysis |
| topic | pulmonary hypertension interstitial lung disease 6-min walk distance (6MWD) treprostinil pulmonary arterial hypertension (PAH) |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.992879/full |
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