التفاصيل البيبلوغرافية
| العنوان: |
Comparative Effectiveness of Sotatercept and Approved Add-On Pulmonary Arterial Hypertension Therapies: A Systematic Review and Network Meta-Analysis. |
| المؤلفون: |
Pitre, Tyler, Desai, Kairavi, Mah, Jasmine, Zeraatkar, Dena, Humbert, Marc |
| المصدر: |
Annals of the American Thoracic Society; Aug2024, Vol. 21 Issue 8, p1194-1203, 10p |
| مصطلحات موضوعية: |
PULMONARY arterial hypertension, ENDOTHELIN receptors, DATA extraction |
| مستخلص: |
Background: There are no direct comparisons of sotatercept to add-on therapies approved for pulmonary arterial hypertension (PAH). Objective: This study aimed to compare the efficacy and safety of add-on sotatercept versus other add-on therapies using a network meta-analysis. Data Sources: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and clinicaltrials.gov until April 15, 2023, for randomized trials involving patients with PAH who were treated with add-on sotatercept or other add-on PAH therapies. Data Extraction: Data extraction and risk-of-bias assessments were performed independently and in duplicate using the Cochrane RoB 2.0 tool. We performed a frequentist random-effects network meta-analysis using the restricted maximum-likelihood estimator and assessed the certainty of evidence using the GRADE (grading of recommendations assessment development, and evaluation) approach. Synthesis: Our search found 18 trials (5,777 patients) eligible for analysis. Sotatercept reduces clinical worsening as compared with placebo (relative risk [RR], 0.21; 95% confidence interval [CI] = 0.11–0.41; with high certainty). Sotatercept probably reduces clinical worsening more, compared with add-on endothelin receptor antagonists (RR, 0.28; 95% CI = 0.14–0.55), inhaled prostanoid (RR, 40.21; 95% CI = 0.07–0.67), and prostanoid taken orally (RR, 0.32; 95% CI = 0.16–0.67; all with moderate certainty). Sotatercept probably improves 6-minute-walk distance compared with placebo (mean difference [MD], 36.89 m; 95% CI = 25.26–48.51). Although sotatercept probably improves 6-minute-walk distance more than add-on endothelin receptor antagonists (MD, 18.38 m; 95% CI = 5.92–30.84) and prostanoid taken orally (MD, 25.66 m; 95% CI = 13.71–37.61), it did not exceed the minimal clinically important difference of 33 m (both with moderate certainty). Conclusions: Sotatercept is an effective add-on therapy for PAH, likely superior to many approved add-on PAH therapies in reducing clinical worsening. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
