A Meta Analysis Of Endothelin Receptor Antagonist Combined With Phosphodiesterase Type 5 Inhibitor In The Treatment Of Pulmonary Arterial Hypertension-based On RCT

ObjectiveTo evaluate the efficacy and safety of endothelin receptor antagonist combined with phosphodiesterase type 5 in the treatment of pulmonary arterial hypertension.MethodA search in PubMed,EMBASE,Cochrane Library was conducted to obtain a randomized controlled trial(RCT)of endothelin receptor antagonist combined with phosphodiesterase type 5 inhibitor in the treatment of pulmonary hypertension,and a final search was conducted in January 2018.ResultsFive randomized controlled clinical trials were included,involving 1151 patients.All test periods ranged from 12 weeks to 24 weeks.After treatment,patients treated with an endothelin receptor antagonist combined with a phosphodiesterase type 5 inhibitor received an average of 25.17 meters in a 6-minute walk than patients in the placebo group(95%CI 15.65-34.68 meters).And,the rate of clinical exacerbation was also lower in the combined treatment group than in the placebo group(OR 0.52;95%CI 0.38-0.71).No significant increase in drug-related adverse reactions.ConclusionsEndothelin receptor antagonist combined with 5-phosphodiesterase inhibitor therapy can improve exercise capacity(6MWD)in patients with pulmonary arterial hypertension,reducing the rate of clinical deterioration of patients,and compared with monotherapy,there was no significant increase in drug-related adverse events,however,combination therapy did not significantly improve the WHO functional class,nor did it reduce mortality in patients with pulmonary hypertension.