Benefits of Macitentan in Patients with Pulmonary Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Global Heart Pub Date : 2023-10-26 eCollection Date: 2023-01-01 DOI:10.5334/gh.1274

Jinlv Qin, Guizuo Wang, Dong Han

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Abstract

Background: This systematic review and meta-analysis aimed to determine the efficacy of macitentan in patients with pulmonary hypertension (PH).

Methods: A systematic search was made of PubMed, Embase, Cochrane Library, and clinicaltrials.gov, without language restrictions. Randomized controlled trials (RCTs) on treatment of PH with macitentan, compared with placebo or blank, were reviewed. Studies were pooled to weighted mean differences (WMDs) and risk ratios (RRs), with 95% confidence intervals (CIs).

Results: Six RCTs (enrolling 1,003 participants) met the inclusion criteria. Macitentan showed significant effects on 6-min walk distance (6MWD) (WMD 12.06 m, 95% CI 2.12 to 21.99 m), pulmonary vascular resistance (PVR) (WMD -186.51 dyn·s/cm^-5, 95% CI -232.72 to -140.29 dyn·s/cm^-5), mean pulmonary artery pressure (mPAP) (WMD -3.20 mmHg, 95% CI -5.93 to -0.47 mmHg), N-terminal pro-brain natriuretic peptide (NT-proBNP) (WMD -232.47 ng/L, 95% wCI -318.22 to -146.72 ng/L), and cardiac index (WMD 0.39 L/min/m², 95% CI 0.20 to 0.58 L/min/m²).

Conclusion: Macitentan significantly improved 6MWD, PVR, mPAP, NT-proBNP, and cardiac index in patients with PH. Macitentan should be further validated in patients with PH.

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麦西坦坦对肺动脉高压患者的益处：随机对照试验的系统评价和荟萃分析。

背景：本系统综述和荟萃分析旨在确定马西坦治疗肺动脉高压（PH）患者的疗效。方法：系统检索PubMed、Embase、Cochrane Library和clinicaltrials.gov，不受语言限制。对马西坦治疗PH的随机对照试验（RCT）与安慰剂或空白对照进行了比较。将研究合并为加权平均差（WMD）和风险比（RR），置信区间为95%。结果：6项随机对照试验（1003名参与者）符合纳入标准。Macitentan对6分钟步行距离（6MWD）（WMD 12.06 m，95%CI 2.12至21.99 m）、肺血管阻力（PVR）（WMD-186.51 dyn·s/cm-5，95%CI-232.72至-140.29 dyn·s/cm-5）、平均肺动脉压（mPAP）（WMD-3.20 mmHg，95%CI-5.93至-0.47 mmHg）、N-末端脑钠肽原（NT-proBNP）（WMD-232.47 ng/L，95%wCI-318.22至-146.72 ng/L）有显著影响，和心脏指数（WMD 0.39L/min/m2、95%CI 0.20至0.58L/min/m2）。结论：马西坦能显著改善PH患者的6MWD、PVR、mPAP、NT-proBNP和心脏指数。

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来源期刊

Global Heart Medicine-Cardiology and Cardiovascular Medicine

CiteScore

5.70

自引率

5.40%

发文量

审稿时长

5 weeks

期刊介绍： Global Heart offers a forum for dialogue and education on research, developments, trends, solutions and public health programs related to the prevention and control of cardiovascular diseases (CVDs) worldwide, with a special focus on low- and middle-income countries (LMICs). Manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent CVDs and the underlying factors. The emphasis should be on approaches applicable in settings with limited resources. Economic evaluations of successful interventions are particularly welcome. We will also consider negative findings if important. While reports of hospital or clinic-based treatments are not excluded, particularly if they have broad implications for cost-effective disease control or prevention, we give priority to papers addressing community-based activities. We encourage submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations related to prevention. Global Heart is particularly interested in publishing data from updated national or regional demographic health surveys, World Health Organization or Global Burden of Disease data, large clinical disease databases or registries. Systematic reviews or meta-analyses on globally relevant topics are welcome. We will also consider clinical research that has special relevance to LMICs, e.g. using validated instruments to assess health-related quality-of-life in patients from LMICs, innovative diagnostic-therapeutic applications, real-world effectiveness clinical trials, research methods (innovative methodologic papers, with emphasis on low-cost research methods or novel application of methods in low resource settings), and papers pertaining to cardiovascular health promotion and policy (quantitative evaluation of health programs.