SynthesisChest2017
Comparative Effectiveness of Pharmacologic Interventions for Pulmonary Arterial Hypertension: A Systematic Review and Network Meta-Analysis.
Synthesis in Chest, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 8 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- Overview of Systematic Reviews on Treatments for Pulmonary Arterial Hypertension: Assessing Methodological Quality and Mapping Evidence Gaps.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025Pooled it
- Pulmonary artery denervation versus conventional therapies for PAH: a systematic review and updated network meta-analysis.ESC heart failure · 2024Pooled it
- Medications for the treatment of pulmonary arterial hypertension: a systematic review and network meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2022Pooled it
- Evidence synthesis in pulmonary arterial hypertension: a systematic review and critical appraisal.BMC pulmonary medicine · 2020Pooled it
- American Society of Hematology 2019 guidelines for sickle cell disease: cardiopulmonary and kidney disease.Blood advances · 2019Guideline
- Effect of Combination Therapy of Endothelin Receptor Antagonist and Phosphodiesterase-5 Inhibitor on Clinical Outcome and Pulmonary Haemodynamics in Patients with Pulmonary Arterial Hypertension: A Meta-Analysis.Clinical drug investigation · 2019Pooled it
- Effects of Weight-Loss Medications on Cardiometabolic Risk Profiles: A Systematic Review and Network Meta-analysis.Gastroenterology · 2018Pooled it
- Pooled it
- Pulmonary arterial hypertension treatment: an individual participant data network meta-analysis.European heart journal · 2024Article
- Genetic and epigenetic factors of arterial hypertension: a bibliometric- and in-silico-based analyses.Frontiers in molecular biosciences · 2023Review
- Aggressive Afterload Lowering to Improve the Right Ventricle: A New Target for Medical Therapy in Pulmonary Arterial Hypertension?American journal of respiratory and critical care medicine · 2022Article
- Real-world treatment patterns, healthcare resource utilization, and cost among adults with pulmonary arterial hypertension in the United States.Pulmonary circulation · 2022Article
- Efficacy and safety of novel-targeted drugs in the treatment of pulmonary arterial hypertension: a Bayesian network meta-analysis.Drug delivery · 2021Article
- Epigenetic Inheritance Underlying Pulmonary Arterial Hypertension.Arteriosclerosis, thrombosis, and vascular biology · 2019Review
- A Bayesian network meta-analysis on the efficacy and safety of eighteen targeted drugs or drug combinations for pulmonary arterial hypertension.Drug delivery · 2018Article
- Nitric Oxide-Independent Soluble Guanylate Cyclase Activation Improves Vascular Function and Cardiac Remodeling in Sickle Cell Disease.American journal of respiratory cell and molecular biology · 2018Article
- Early intervention in the management of pulmonary arterial hypertension: clinical and economic outcomes.ClinicoEconomics and outcomes research : CEOR · 2017Review
- Combination therapy in pulmonary arterial hypertension: recent accomplishments and future challenges.Pulmonary circulationArticle
- Long-term outcomes in pulmonary arterial hypertension by functional class: a meta-analysis of randomized controlled trials and observational registries.Pulmonary circulationArticle
- Treatment patterns, healthcare resource utilization, and healthcare costs among patients with pulmonary arterial hypertension in a real-world US database.Pulmonary circulationArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundWe conducted a systematic review and network meta-analysis to examine comparative efficacy and tolerability of pharmacologic interventions for pulmonary arterial hypertension (PAH).
methodsMEDLINE, the Cochrane Register, EMBASE, CINAHL, and clinicaltrials.gov were searched (January 1, 1990 to March 3, 2016). Randomized controlled trials (RCTs) studying the approved pharmacologic agents endothelin receptor antagonists (ERA), phosphodiesterase inhibitors (PDE5i), the oral/inhaled (PO/INH) and IV/subcutaneous (SC) prostanoids, and riociguat and selexipag, alone or in combination, for pulmonary arterial hypertension (PAH) and reporting at least one efficacy outcome were selected.
resultsThirty-one RCTs with 6,565 patients were selected. In network meta-analysis, when compared with a median placebo rate of 14.5%, clinical worsening was estimated at 2.8% with riociguat (risk ratio [RR], 0.19; 95% CI, 0.05-0.76); at 3.9% with ERA + PDE5i (RR, 0.27; 95% CI, 0.14-0.52), and at 5.7% with PDE5i (RR, 0.39; 95% CI, 0.24-0.62). For improvement in functional status, when compared with 16.2% in the placebo group, improvement in at least one New York Heart Association/World Health Organization (NYHA/WHO) functional class was estimated at 81.8% with IV/SC prostanoids (RR, 5.06; 95% CI, 2.3211.04), at 28.3% with ERA + PDE5i (RR, 1.75; 95% CI, 1.05-2.92), and at 25.2% with ERA (RR, 1.56; 95% CI, 1.22-2.00). Differences in mortality were not significant. Adverse events leading to discontinuation of therapy were highest with the PO/INH prostanoids (RR, 2.92; 95% CI, 1.68-5.06) and selexipag (RR, 2.06; 95% CI, 1.04-3.88) compared with placebo.
conclusionsCurrently approved pharmacologic agents have varying effects on morbidity and functional status in patients with PAH. Future comparative effectiveness trials are warranted with a focus on a patient-centered approach to therapy. REGISTRATION: PROSPERO CRD42016036803.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.