Curative effect and tolerability of endothelin receptor antagonists in treatment of pulmonary arterial hypertension：a network Meta-analysis
LIANG Fu-xiang
SONG Bing
QI Quan
LI Yuan-min
LIU Rui-sheng
Abstract：Objective To compare the curative effect and tolerability of 4 kinds of endothelin receptor antagonists (ambrisentan, bosentan, sitaxsentan and macitentan) in treatment of pulmonary arterial hypertension (PAH) by applying network Meta-analysis.Methods The databases of PubMed, EMBase, Cochrane Library, CBM, CNKI and WanFang Database were retrieved with computer until Jan. 31, 2014 for collecting randomized controlled trials (RCT) about treatment of PAH with 4 kinds of endothelin receptor antagonists. The primary outcome indexes were curative effect and tolerability and secondary ones were mortality and clinical worsening rate. All data was screened, extracted and reviewed by 2 researchers independently, compared directly and given network Meta-analyzed by using RevMan5.2 software and GEMTC software.Results There were 12 documents enclosed including 13 RCT involving 2191 patients. The direct Meta-analysis showed that the curative effect of 4 kinds of endothelin receptor antagonists was all better than that of placebo, and tolerability of only ambrisentan was better than that of placebo. The network Meta-analysis showed that the curative effect of ambrisentan and bosentan was better than that of placebo. The rank probability plot showed that the curative effect of ambrisentan was the best and then bosentan, sitaxsentan and macitentan in a descending order. The tolerability of ambrisentan and sitaxsentan were better than that of placebo. The rank probability plot showed that the tolerability of ambrisentan was the highest and then sitaxsentan, macitentan and bosentan in a descending order.Conclusion Among 4 kinds of endothelin receptor antagonists, ambrisentan is superior to other 3 in curative and tolerability. In the future studies, the effects of ambrisentan and other drugs on mortality and clinical worsening rate should be paid more attention to. In addition the curative effects of different drug dosage and specific effect on different types of PAH patients should be investigated.
Keywords：Endothelin receptor antagonistsPulmonary arterial hypertensionAmbrisentanBosentanSitaxsentanMacitentanNetwork Meta-analysis
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 663-669 )