The authors of the study titled “Medications for the treatment of pulmonary arterial hypertension: a systematic review and network meta-analysis” conducted a search on MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and Clinicaltrials.gov, from inception to December 2021, which yielded 5.006 records, of which the full texts of 222 records were reviewed and 53 randomised controlled trials (RCTs) on 10.670 patients were included in the analysis.
The study found moderate-to-high certainty that current pulmonary arterial hypertension treatments improve clinically relevant outcomes, including reduced clinical worsening and mortality, as well as improved 6MWD and cardiac function. Overall, the data supports the current clinical practice guidelines recommendations for combination pulmonary hypertension-targeted therapy in most PAH patients, say the authors, especially those at intermediate-to-high risk of future clinical worsening and premature mortality. However, the authors also point out to some of the limitations of the study (e.g. benefits vary between treatments, in part because the evidence base is limited by relatively small, largely placebo-controlled RCTs with few active treatment comparative trials, as well as heterogeneity of RCT study populations and comprehensiveness of outcome assessment) and emphasise that caution in making firm conclusions about the findings without further context must be exercised.
Tyler Pitre, Johnny Su, Sonya Cui, Ryan Scanlan, Christopher Chiang, Renata Husnudinov, Muhammad Faran Khalid, Nadia Khan, Gareth Leung, David Mikhail, Pakeezah Saadat, Shaneela Shahid, Jasmine Mah, Lisa Mielniczuk, Dena Zeraatkar, Sanjay Mehta, European Respiratory Review 2022 31: 220036; DOI: 10.1183/16000617.0036 – 2022
Read more at this link on the European Respiratory Review website