The efficiency of endothelin receptor antagonist bosentan for pulmonary arterial hypertension associated with congenital heart disease: A systematic review and meta-analysis.
Medicine (Baltimore)
; 97(10): e0075, 2018 Mar.
Article
en En
| MEDLINE
| ID: mdl-29517668
ABSTRACT
BACKGROUND:
Oral bosentan has been widely applied in pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD). A systemic review and meta-analysis was conducted for a therapeutic evaluation of oral bosentan in both adult and pediatric patients with PAH-CHD. The acute responses and a long-term effect were respectively assessed in a comparison with baseline characteristics, and the improvement of exercise tolerance was analyzed.METHODS:
PubMed, Medline, Embase, and Cochrane Central Register of clinical controlled trails or observational studies have been searched for a recording of bosentan effects on the PAH-CHD participants. For mortality and rate of adverse events (AEs), it was described in detail. Randomized-effects model or fixed-effects model was used to calculate different effective values with a sensitivity analysis.RESULTS:
Seventeen studies were pooled in this review, and 3 studies enrolled the pediatric patients. Among all studies, 456 patients were diagnosed with PAH-CHD, and 91.7% were treated with oral bosentan. With a term less than 6 months of bosentan therapy, there existed a significant improvement in 6-minute walk distance (6MWD) and the World Health Organization functional class (WHO-FC), but no such differences in Borg dyspnea index scores (BDIs) and the resting oxygen saturation (SpO2). Although with a prolonged treatment, not only 6MWD and FC, but also the resting SpO2 and heart rate were changed for a better exercise capability. Additionally, compared with the basic cardiopulmonary hemodynamics, it showed a statistically significant difference in mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance index (PVRi). Although a limitation of pooled studies with comparative outcomes of different terms, outcomes presented a lower WHO-FC which contributes to a success in a prolonged treatment.CONCLUSIONS:
Bosentan in PAH-CHD is well established and still requires clinical trials for an identification of its efficiency on CHD patients for an optimized period lessening a serious complication and the common AEs.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
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6_ODS3_enfermedades_notrasmisibles
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7_ODS3_muertes_prevenibles_nacidos_ninos
Problema de salud:
2_cobertura_universal
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2_muertes_prevenibles
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6_cardiovascular_diseases
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6_congenital_chromosomal_anomalies
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6_other_circulatory_diseases
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6_other_respiratory_diseases
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7_neonatal_care_health
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7_non_communicable_diseases
Asunto principal:
Sulfonamidas
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Hipertensión Pulmonar Primaria Familiar
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Antagonistas de los Receptores de Endotelina
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Cardiopatías Congénitas
Tipo de estudio:
Clinical_trials
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
/
Systematic_reviews
Límite:
Adolescent
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Adult
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Child
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Child, preschool
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Humans
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Infant
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Middle aged
Idioma:
En
Revista:
Medicine (Baltimore)
Año:
2018
Tipo del documento:
Article
País de afiliación:
India