Efficacy And Safty Of Treprostinil Therapy In Pulmonary Hypertension:Meta Analysis

Objective:Many clinical trials have demonstrated treprostinil canimprove6MWD,dyspnea and hemodynamics in patients with PAH.Toassesse the efficacy and safety of treprostinil in patients with PAH,wecarried a Meta-analysis through selecting RCTs.,which provides reliableproof for clinic.Methods：We surveyed RCTs of the efficacy and safety of treprostinilin patients with PAH using database like PubMed、 EMBASE andCNKI.Meta-analysis of RCTs was performed to determine treatmentefficacy and safety outcomes.Results:According to the Inclusion criteria，seven RCTs including atotal of814patients treated with treprostinil and679controls were chosento assesse the short-term efficacy and safety of treprostinil in patientswith PAH.Compared with the placebo,treprostinil could improve exercisecapacity of patients with PAH:①6MWD increased34.94m（95%CI:-6.40一76.29,P=0.1）;②Descreased Bory dysponea score by0.99（95%CI:-1.47一-0.50，P<0.05）;③Increased cardiac index by0.19L/min.m2(95%CI:0.08一0.30,P<0.05);④mPAP decreased by2.71mmHg(95%CI:-4.20一-1.23， P<0.05);⑤PVR decreased by4.73mmHg(95%CI:-6.30一-3.17，P<0.05);⑥The total RR of mortality in PAH patients treated withtreprostinil was0.71（95%CI:0.42一1.18，P=0.19）;⑦The total RR ofclinical worsening of symptoms in patients with PAH who are treated withtreprostinil was0.57（95%CI:0.34一0,96，P=0.03）;⑧Adverse events likeheadache,the total RR was1.70（95%CI:1.26一2.30，P<0.05）.Conclusions:Treprostinil therapy can improve cardiacfunction,clinical symptoms and hemodynamics,decrease mPAP andPVR,and delay clinical deterioation,but cannot decrease the mortality inPAH patients in short-term. The risk of adverse events like headacheincreases in PAH patients treated with treprostinil,but many patients canbear it.