Evidence map›Paper›PMID 35948391›Full record

SynthesisEuropean respiratory review : an official journal of the European Respiratory Society2022

Medications for the treatment of pulmonary arterial hypertension: a systematic review and network meta-analysis.

Tyler Pitre, Johnny Su, Sonya Cui, Ryan Scanlan, Christopher Chiang, Renata Husnudinov, Muhammad Faran Khalid, Nadia Khan, Gareth Leung, David Mikhail and 6 more

Open access · diamondAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European respiratory review : an official journal of the European Respiratory Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. Review
  13. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 7 institutions in 2 countries.

Tyler PitreDivision of Internal Medicine, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0003-3015-0723
Johnny SuDivision of Internal Medicine, McMaster University, Hamilton, ON, Canada.
Sonya CuiMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Ryan ScanlanDivision of Internal Medicine, McMaster University, Hamilton, ON, Canada.
Christopher ChiangDivision of Internal Medicine, McMaster University, Hamilton, ON, Canada.
Renata HusnudinovMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Muhammad Faran KhalidMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Nadia KhanSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Gareth LeungFaculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
David MikhailFaculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Pakeezah SaadatInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Shaneela ShahidHealth Research Methods Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Jasmine MahDept of Medicine, Dalhousie University, Halifax, NS, Canada.
Lisa MielniczukUniversity of Ottawa Heart Institute, Ottawa, ON, Canada.
Dena ZeraatkarHealth Research Methods Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Sanjay MehtaSouthwest Ontario PH Clinic, Division of Respirology, Dept of Medicine, Lawson Health Research Institute, London Health Sciences Centre, Schulich School of Medicine, Western University, London, ON, Canada.ORCID https://orcid.org/0000-0002-7707-1056
McMaster University · CAUniversity of Ottawa · CAWestern University · CADalhousie University · CAHarvard University · USImpact · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is no consensus on the most effective treatments of pulmonary arterial hypertension (PAH). Our objective was to compare effects of medications for PAH.

methodsWe searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and Clinicaltrials.gov from inception to December 2021. We performed a frequentist random-effects network meta-analysis on all included trials. We rated the certainty of the evidence using the Grades of Recommendation, Assessment, Development, and Evaluation approach.

resultsWe included 53 randomised controlled trials with 10 670 patients. Combination therapy with endothelin receptor antagonist (ERA) plus phosphodiesterase-5 inhibitors (PDE5i) reduced clinical worsening (120.7 fewer events per 1000, 95% CI 136.8-93.4 fewer; high certainty) and was superior to either ERA or PDE5i alone, both of which reduced clinical worsening, as did riociguat monotherapy (all high certainty). PDE5i (24.9 fewer deaths per 1000, 95% CI 35.2 fewer to 2.1 more); intravenous/subcutaneous prostanoids (18.3 fewer deaths per 1000, 95% CI 28.6 fewer deaths to 0) and riociguat (29.1 fewer deaths per 1000, 95% CI 38.6 fewer to 8.7 more) probably reduce mortality as compared to placebo (all moderate certainty). Combination therapy with ERA+PDE5i (49.9 m, 95% CI 25.9-73.8 m) and riociguat (49.5 m, 95% CI 17.3-81.7 m) probably increase 6-min walk distance as compared to placebo (moderate certainty).

conclusionCurrent PAH treatments improve clinically important outcomes, although the degree and certainty of benefit vary between treatments.

Indexed as

Pulmonary Arterial HypertensionHumans

Identifiers

PMID35948391
PMCPMC9724821
OpenAlexW4291021363

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.