Comparative efficacy and acceptability of endothelin receptor antagonists for pulmonary arterial hypertension: A network meta-analysis

Duo-Ji, Mi-Ma; Long, Ziwen

doi:10.1016/j.ijcard.2016.12.092

Cited by 14 publications

(26 citation statements)

References 38 publications

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“…Duo-Ji and Long carried out a network meta-analysis for multiple comparisons among PAH therapies: in 2,172 patients, all four ERAs increased mean 6MWD significantly in comparison with placebo. 73 Moreover, Bosentan and ambrisentan showed a significant association with a reduction in risk of clinical worsening compared with placebo. With regard to all-cause discontinuation, ambrisentan was the only therapy associated significantly with a risk reduction compared with placebo.…”

Section: Resultsmentioning

confidence: 97%

Endothelin-receptor antagonists in the management of pulmonary arterial hypertension: where do we stand?

Correale

Ferraretti

Monaco

et al. 2018

VHRM

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Pulmonary arterial hypertension, a disease largely neglected until a few decades ago, is presently the object of intense studies by several research teams. Despite considerable progress, pulmonary arterial hypertension remains a major clinical problem, because it is not always easy to diagnose, treat, and prevent. The disease was considered incurable until the late 1990s, when Epoprostenol was introduced as the first tool against this illness. More recently, therapy for pulmonary arterial hypertension gained momentum after publication of the SERAPHIN and AMBITION trials, which also highlighted the importance of upfront therapy. This review also focuses on recent substudies from these trials and progress in drugs targeting the endothelin pathway. Future perspectives with regard to endothelin-receptor antagonists are also discussed.

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Section: Resultsmentioning

confidence: 97%

Endothelin-receptor antagonists in the management of pulmonary arterial hypertension: where do we stand?

Correale

Ferraretti

Monaco

et al. 2018

VHRM

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“…al., and Duo-Ji et.al. had made some attempts to investigate specific drugs, they were confined to oral medications or medications within the same category, such as prostacyclin analogs and ERAs (Igarashi et al., 2016 ; Zhang et al., 2016 ; Duo-Ji & Long, 2017 ). Meanwhile, these literatures offered another thought that it might be meaningful to make a subgroup analysis on dosage or drug delivery.…”

Section: Discussionmentioning

confidence: 99%

A Bayesian network meta-analysis on the efficacy and safety of eighteen targeted drugs or drug combinations for pulmonary arterial hypertension

Wang

Zheng

et al. 2018

Drug Delivery

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Pulmonary arterial hypertension (PAH) can be relieved by pharmacological interventions, especially the targeted drug, which is classified into endothelin receptor antagonist, phosphodiesterase 5 inhibitor, prostaglandin I2, soluble guanylate cyclase stimulator and selective non-prostanoid prostacyclin receptor agonist. To solve the contradictions existing in reported trials and provide a comprehensive guideline for clinical practice. PubMed, Embase, Cochrane library, and clinicaltrials.gov were searched. The basic information about the article, trial, arm, intervention, and the detailed data of outcome, including 6 minutes walking distance (6MWD) change, WHO functional class (FC) improvement, Borg dyspnea score (BDS) change, cardiac index (CI) change, mean pulmonary arterial pressure (mPAP) change, mean right arterial pressure (mRAP) change, pulmonary vascular resistance (PVR) change, clinical worsening, hospitalization, death, severe adverse events (SAEs), and withdrawal were extracted. The rank of treatments was estimated. 10,230 cases provided the firsthand comparison data about targeted drugs for treating PAH. For 6MWD, ambrisentan + tadalafil, vardenafil, and sildenafil + bosentan were better than others. Epoprostenol, macitentan, and sildenafil represented a greater WHO FC improvement. Vardenafil and treprostinil were better for BDS. So were bosentan + epoprostenol and bosentan alone for CI. Iloprost plus bosentan, bosentan + epoprostenol, and epoprostenol were better for mPAP. Iloprost plus bosentan, bosentan alone, and selexipag could reduce PVR. Sildenafil, epoprostenol, and vardenafil had the highest probability to reduce the incidence of death and withdrawal. To conclude, vardenafil and iloprost + bosentan showed relatively better performance in both efficacy and safety. However, the therapeutic choice should be made according to both the feature of each therapy and the individual condition.

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“…The absence of trials that have directly compared ERA treatments complicates the efficacy assessments of different treatment regimens. Network metanalyses suggest that ambrisentan might be the most appropriate treatment regarding efficacy and tolerability [57]. However, the safety and efficacy, especially of macitentan, must be evaluated in future studies with PAH patients.…”

Section: Finally In the Seraphin Trial (Study With An Endothelin Recmentioning

confidence: 99%

Endothelin Receptor Antagonists: Status Quo and Future Perspectives for Targeted Therapy

Enevoldsen

Sahana

Wehland

et al. 2020

JCM

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The endothelin axis, recognized for its vasoconstrictive action, plays a central role in the pathology of pulmonary arterial hypertension (PAH). Treatment with approved endothelin receptor antagonists (ERAs), such as bosentan, ambrisentan, or macitentan, slow down PAH progression and relieves symptoms. Several findings have indicated that endothelin is further involved in the pathogenesis of certain other diseases, making ERAs potentially beneficial in the treatment of various conditions. In addition to PAH, this review summarizes the use and perspectives of ERAs in cancer, renal disease, fibrotic disorders, systemic scleroderma, vasospasm, and pain management. Bosentan has proven to be effective in systemic sclerosis PAH and in decreasing the development of vasospasm-related digital ulcers. The selective ERA clazosentan has been shown to be effective in preventing cerebral vasospasm and delaying ischemic neurological deficits and new infarcts. Furthermore, in the SONAR (Study Of Diabetic Nephropathy With Atrasentan) trial, the selective ERA atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease. These data suggest atrasentan as a new therapy in the treatment of diabetic nephropathy and possibly other renal diseases. Preclinical studies regarding heart failure, cancer, and fibrotic diseases have demonstrated promising effects, but clinical trials have not yet produced measurable results. Nevertheless, the potential benefits of ERAs may not be fully realized.

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Comparative efficacy and acceptability of endothelin receptor antagonists for pulmonary arterial hypertension: A network meta-analysis

Cited by 14 publications

References 38 publications

Endothelin-receptor antagonists in the management of pulmonary arterial hypertension: where do we stand?

Endothelin-receptor antagonists in the management of pulmonary arterial hypertension: where do we stand?

A Bayesian network meta-analysis on the efficacy and safety of eighteen targeted drugs or drug combinations for pulmonary arterial hypertension

Endothelin Receptor Antagonists: Status Quo and Future Perspectives for Targeted Therapy

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