A Meta-analysis On The Efficacy And Safety Of Targeted Drug Combination Therapy In Pulmonary Arterial Hypertension

ObjectiveTo evaluate the efficacy and safety of targeted drug combination therapy in pulmonary hypertension.MethodsThe PubMed,EMBASE,and Cochrane libraries were searched for randomized controlled trials of targeted drug combination for pulmonary hypertension.The search time was limited to 2008-2019.Quality assessment and data extraction were conducted by two reviewers independently.All data were analyzed by using Review Manager 5.3.Resultseight eligible trials including 2078 patients were identified.The results showed that,compared to monotherapy,combination treatment significantly increased the 6-minute walkdistance at the end of follow-up(MD=15.42 meters,95%CI=2.99~27.84),and the latter had a lower clinical worseningrisk ratio(OR=0.52,95%CI=0.40~0.67,and drug-related adverse events did not increase significantly(OR=1.37,95%CI=0.70~2.71).However,combination therapy could not reduce mortality(OR= 0.66,95%CI = 0.40~1.09).ConclusionTargeted drug combination therapy can improve the exercise capacity in patients with pulmonary hypertension,and reduce clinical worsening.Moreover,it is safe and well tolerated.However,it can’t improve patients′ survival.