Systematic Review and Meta-Analysis of Pulmonary Hypertension Specific Therapy for Exercise Capacity in Chronic Obstructive Pulmonary Disease.
10.3346/jkms.2013.28.8.1200
- Author:
Jinkyeong PARK
1
;
Ju Hee SONG
;
Dong Ah PARK
;
Jae Seoung LEE
;
Sang Do LEE
;
Yeon Mok OH
Author Information
1. Department of Pulmonary and Critical Care Medicine Wonkwang University, Sanbon Hospital, Gunpo, Korea.
- Publication Type:Original Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Review
- Keywords:
COPD;
Pulmonary Hypertension;
Vasodilator;
Exercise
- MeSH:
Anoxia;
Antihypertensive Agents/adverse effects/*therapeutic use;
Clinical Trials as Topic;
Databases, Factual;
Epoprostenol/adverse effects/analogs & derivatives/therapeutic use;
Humans;
Hypertension, Pulmonary/complications/*drug therapy;
Piperazines/adverse effects/therapeutic use;
Pulmonary Disease, Chronic Obstructive/*etiology;
Purines/adverse effects/therapeutic use;
Questionnaires;
Risk Factors;
Sulfonamides/adverse effects/therapeutic use;
Sulfones/adverse effects/therapeutic use
- From:Journal of Korean Medical Science
2013;28(8):1200-1206
- CountryRepublic of Korea
- Language:English
-
Abstract:
Some patients with chronic obstructive pulmonary disease (COPD) have pulmonary hypertension (PH) that adversely affects survival. We performed a systematic review and meta-analysis to assess whether PH-specific therapies have an effect for stable COPD. Data sources were Medline, EMBASE, Cochrane Central Register of Controlled Trials, Korea med and references from relevant publications. Randomized prospective trials that compared PH specific therapy in COPD for more than 6 weeks with placebo were included. The outcomes were the exercise capacity and adverse events. Four randomized controlled trials involving 109 subjects were included in the analysis. Two trials involved bosentan, one sildenafil and one beraprost. The studies varied in duration of treatment from 3 to 18 months. In a pooled analysis of four trials, exercise-capacity was not significantly improved with PH-specific treatment for COPD (risk ratio, -5.1; 95% CI, -13.0 to 2.8). COPD with overt PH significantly improved the exercise capacity (mean difference, 111.6; 95% CI, 63.3 to 159.9) but COPD with PH unknown did not (mean difference, 26.6; 95% CI, -24.3 to 77.5). There was no significant difference in hypoxemia (mean difference, 2.6; 95% CI, -3.7 to 8.8). PH specific treatments have a significant effect in improving exercise capacity in COPD with overt PH.
