The Antihypertensive Effects and Safety of LCZ696 in Patients with Hypertension: A Systemic Review and Meta-Analysis of Randomized Controlled Trials
Background: The management of hypertension remains suboptimal throughout the world. Methods: We performed a random-effects model meta-analysis of randomized controlled trials to determine the effectiveness and safety of sacubitril/valsartan (LCZ696) for the treatment of high arterial pressure. Relev...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/13/2824 |
| _version_ | 1797528614124650496 |
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| author | Su-Kiat Chua Wei-Ting Lai Lung-Ching Chen Huei-Fong Hung |
| author_facet | Su-Kiat Chua Wei-Ting Lai Lung-Ching Chen Huei-Fong Hung |
| author_sort | Su-Kiat Chua |
| collection | DOAJ |
| description | Background: The management of hypertension remains suboptimal throughout the world. Methods: We performed a random-effects model meta-analysis of randomized controlled trials to determine the effectiveness and safety of sacubitril/valsartan (LCZ696) for the treatment of high arterial pressure. Relevant published articles from PubMed, Cochrane base, and Medline were examined, and the last search date was December 2020. Only published randomized controlled trials and double-blind studies were selected for further analysis. The mean reductions in systolic blood pressure (msSBP) and diastolic blood pressure (msDBP) in the sitting position, as well as the mean reductions in ambulatory systolic blood pressure (maSBP) and ambulatory diastolic blood pressure (maDBP), were assumed as efficacy endpoints. Adverse events (AEs) were considered as safety outcomes. Results: Ten studies with a total of 5931patients were included for analysis. Compared with placebo, LCZ696 had a significant reduction in msSBP (weight mean difference (WMD) = −6.52 mmHg, 95% confidence interval (CI): −8.57 to −4.47; <i>p</i> < 0.001), msDBP (WMD = −3.32 mmHg, 95% CI: −4.57 to −2.07; <i>p</i> < 0.001), maSBP (WMD = −7.08 mmHg, 95% CI: −10.48 to −3.68; <i>p</i> < 0.001), maDBP (WMD = −3.57 mmHg, 95% CI: −5.71 to −1.44, <i>p</i> < 0.001). In subgroup analysis, only 200 mg and 400 mg LCZ696 showed a significant BP reduction. There was no difference in the AE rate between the LCZ696 and placebo groups (WMD = 1.02, 95% CI: 0.83 to 1.27, <i>p</i> = 0.54). Egger’s test revealed a potential publication bias for msSBP (<i>p</i> = 0.025), but no publication bias for other outcomes. Conclusion: LCZ696 may reduce blood pressure more efficaciously than traditional therapy in hypertensive patients without increasing adverse effects. |
| first_indexed | 2024-03-10T10:01:52Z |
| format | Article |
| id | doaj.art-a9ebfeada85a4279a2a088624dcdab3e |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T10:01:52Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-a9ebfeada85a4279a2a088624dcdab3e2023-11-22T01:53:19ZengMDPI AGJournal of Clinical Medicine2077-03832021-06-011013282410.3390/jcm10132824The Antihypertensive Effects and Safety of LCZ696 in Patients with Hypertension: A Systemic Review and Meta-Analysis of Randomized Controlled TrialsSu-Kiat Chua0Wei-Ting Lai1Lung-Ching Chen2Huei-Fong Hung3School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei 24205, TaiwanDivision of Cardiology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111045, TaiwanDivision of Cardiology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111045, TaiwanDivision of Cardiology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111045, TaiwanBackground: The management of hypertension remains suboptimal throughout the world. Methods: We performed a random-effects model meta-analysis of randomized controlled trials to determine the effectiveness and safety of sacubitril/valsartan (LCZ696) for the treatment of high arterial pressure. Relevant published articles from PubMed, Cochrane base, and Medline were examined, and the last search date was December 2020. Only published randomized controlled trials and double-blind studies were selected for further analysis. The mean reductions in systolic blood pressure (msSBP) and diastolic blood pressure (msDBP) in the sitting position, as well as the mean reductions in ambulatory systolic blood pressure (maSBP) and ambulatory diastolic blood pressure (maDBP), were assumed as efficacy endpoints. Adverse events (AEs) were considered as safety outcomes. Results: Ten studies with a total of 5931patients were included for analysis. Compared with placebo, LCZ696 had a significant reduction in msSBP (weight mean difference (WMD) = −6.52 mmHg, 95% confidence interval (CI): −8.57 to −4.47; <i>p</i> < 0.001), msDBP (WMD = −3.32 mmHg, 95% CI: −4.57 to −2.07; <i>p</i> < 0.001), maSBP (WMD = −7.08 mmHg, 95% CI: −10.48 to −3.68; <i>p</i> < 0.001), maDBP (WMD = −3.57 mmHg, 95% CI: −5.71 to −1.44, <i>p</i> < 0.001). In subgroup analysis, only 200 mg and 400 mg LCZ696 showed a significant BP reduction. There was no difference in the AE rate between the LCZ696 and placebo groups (WMD = 1.02, 95% CI: 0.83 to 1.27, <i>p</i> = 0.54). Egger’s test revealed a potential publication bias for msSBP (<i>p</i> = 0.025), but no publication bias for other outcomes. Conclusion: LCZ696 may reduce blood pressure more efficaciously than traditional therapy in hypertensive patients without increasing adverse effects.https://www.mdpi.com/2077-0383/10/13/2824LCZ696ambulatory systolic blood pressurehypertension |
| spellingShingle | Su-Kiat Chua Wei-Ting Lai Lung-Ching Chen Huei-Fong Hung The Antihypertensive Effects and Safety of LCZ696 in Patients with Hypertension: A Systemic Review and Meta-Analysis of Randomized Controlled Trials Journal of Clinical Medicine LCZ696 ambulatory systolic blood pressure hypertension |
| title | The Antihypertensive Effects and Safety of LCZ696 in Patients with Hypertension: A Systemic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full | The Antihypertensive Effects and Safety of LCZ696 in Patients with Hypertension: A Systemic Review and Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | The Antihypertensive Effects and Safety of LCZ696 in Patients with Hypertension: A Systemic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | The Antihypertensive Effects and Safety of LCZ696 in Patients with Hypertension: A Systemic Review and Meta-Analysis of Randomized Controlled Trials |
| title_short | The Antihypertensive Effects and Safety of LCZ696 in Patients with Hypertension: A Systemic Review and Meta-Analysis of Randomized Controlled Trials |
| title_sort | antihypertensive effects and safety of lcz696 in patients with hypertension a systemic review and meta analysis of randomized controlled trials |
| topic | LCZ696 ambulatory systolic blood pressure hypertension |
| url | https://www.mdpi.com/2077-0383/10/13/2824 |
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