The Efficiency And Adverse Effects Of Ambrisentan For Pulmonary Artery Hypertension: Insights From The Meta-Analysis

Objective: Ambrisentan,a selective endothelin receptor antagonists(ERA),has been widely applied in patients with pulmonary artery hypertension(PAH),it is necessary to evaluate the clinical effects and adverse reaction of ambrisentan in PAH.Methods: After systematic searches of PubMed,Embase,Cochrane Library and the Clinical Trials.gov website,randomized controlled trials(RCTs)with patients receiving ambrisentan in at least 1 treatment group were included.The clinical adverse events(AEs)and the efficiency of ambrisentan were evaluated.Summary relative risks and 95% CIs were calculated using random-or fixed-effects models according to between-study heterogeneity.Results: In total,5 randomized trials including 493 patients met the inclusion criteria.At an average follow-up of 24 weeks,the ambrisentan group had increased 37.53 m in 6-minute walk distance(6MWD),decreased clinical worsening,and decreased plasma B-type natriuretic peptide(BNP)concentration.Meta-analysis showed that the incidence of peripheral edema(18.94% versus 7.91%;RR 1.58,95% CI 1.01–2.45,P=0.04),and nasal congestion(7.34% versus 2.04%;RR 3.25,95% CI 1.08–9.79,P=0.04)was significantly higher in the ambrisentan group compared with placebo.Ambrisentan were not found to increase other reported AEs compared with placebo.Conclusions: Ambrisentan in PAH is well established and still requires clinical trials for an identification of its efficiency on PAH patients for an optimized period lessening a serious complication and the common AEs.