Evidence map›Paper›PMID 39658051›Full record

ArticleRMD open2024

Vasodilator drugs and heart-related outcomes in systemic sclerosis: an exploratory analysis.

Alexis F Guédon, Fabrice Carrat, Luc Mouthon, David Launay, Benjamin Chaigne, Grégory Pugnet, Jean-Christophe Lega, Arnaud Hot, Vincent Cottin, Christian Agard and 26 more

Abstract readMulticenter Study
In one paragraph

Article in RMD open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
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

36 authors.

Alexis F GuédonInstitut Pierre Louis d'Epidemiologie et de Sante Publique, Paris, Île-de-France, France alexis.guedon2@aphp.fr.
Fabrice CarratInstitut Pierre Louis d'Epidemiologie et de Sante Publique, Paris, Île-de-France, France.
Luc MouthonDepartment of Internal Medicine, Hopital Cochin, Paris, Île-de-France, France.
David LaunayDepartment of Internal Medicine and Clinical immunology, Referral Centre for Rare Systemic Auto-immune Diseases North and North-West of France, Univ. Lille, Inserm, CHU de Lille, Lille, Hauts-de-France, France.
Benjamin ChaigneDepartment of Internal Medicine, Hopital Cochin, Paris, Île-de-France, France.
Grégory PugnetInternal Medicine Department, CHU Toulouse, Toulouse, Occitanie, France.
Jean-Christophe LegaDepartment of Internal and Vascular Medicine, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France.
Arnaud HotDepartment of Internal Medicine, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France.
Vincent CottinNational Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France.ORCID 0000-0002-5591-0955
Christian AgardService de Médecine Interne, Centre Hospitalier Universitaire de Nantes, Nantes, France.
Yannick AllanoreDepartment of Rheumatology, Hospital Cochin, Paris, Île-de-France, France.ORCID 0000-0002-6149-0002
Anne Laure FauchaisDepartment of Internal Medicine, CHU Limoges, Limoges, Nouvelle-Aquitaine, France.
Alain LescoatDepartment of Internal Medicine and Clinical Immunology, CHU de Rennes, Rennes, Bretagne, France.
Robin DhoteDepartment of Internal Medicine, Hopital Avicenne, Bobigny, France.
Thomas PapoDepartment of Internal Medicine, Hôpital Bichat Claude-Bernard, Paris, Île-de-France, France.
Emmanuel ChatelusRheumatology, Hopitaux universitaires de Strasbourg, Strasbourg, France.
Bernard BonnotteDepartment of Internal Medicine, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, Bourgogne-Franche-Comté, France.ORCID 0000-0001-7229-3808
Jean-Emmanuel KahnDepartment of Internal Medicine, Hopital Ambroise-Pare, Boulogne-Billancourt, Île-de-France, France.
Elisabeth DiotDepartment of Internal Medicine and Clinical Immunology, CHRU de Tours, Tours, Centre-Val de Loire, France.
Achille AoubaDepartment of Internal Medicine, CHU Caen, Caen, Normandie, France.
Nadine Magy-BertrandDepartment of Internal Medicine, Centre Hospitalier Universitaire de Besancon, Besancon, Bourgogne-Franche-Comté, France.
Viviane QueyrelInternal Medicine, CHU Nice, Nice, Provence-Alpes-Côte d'Azu, France.
Alain Le QuellecService de Médecine Interne, CHU de Montpellier, Montpellier, Occitanie, France.
Pierre KiefferService de médecine interne, GHR Mulhouse Sud Alsace, Mulhouse, Grand Est, France.
Zahir AmouraSorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses, Hopital Universitaire Pitie-Salpetriere, Paris, Île-de-France, France.
Brigitte GranelInternal Medicine Department, Assistance Publique - Hopitaux de Marseille, Marseille, Provence-Alpes-Côte d'Azu, France.
Jean Baptiste GaultierService de Médecine Interne, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, Auvergne-Rhône-Alpes, France.
Marie-Hélène BalquetDepartment of Internal Medicine, Centre Hospitalier de Lens, Lens, France.
Denis WahlVascular Medicine and Center for autoimmune diseases, Nancy University Hospital Center, Nancy, Grand Est, France.
Olivier LidoveDepartment of Internal Medicine, Groupe hospitalier Diaconesses Croix Saint-Simon, Paris, Île-de-France, France.
Olivier EspitiaDepartement of internal and vascular medicine, CHU Nantes, Nantes, Pays de la Loire, France.ORCID 0000-0003-0821-9990
Ariel CohenService de cardiologie, Hopital Saint-Antoine, Paris, Île-de-France, France.
Olivier FainSorbonne Université, APHP, Service de Médecine Interne, Hopital Saint-Antoine, Paris, Île-de-France, France.
Eric HachullaDepartment of Internal Medicine and Clinical immunology, Referral Centre for Rare Systemic Auto-immune Diseases North and North-West of France, Univ. Lille, Inserm, CHU de Lille, Lille, Hauts-de-France, France.ORCID 0000-0001-7432-847X
Arsène MekinianSorbonne Université, APHP, Service de Médecine Interne, Hopital Saint-Antoine, Paris, Île-de-France, France.ORCID 0000-0003-2849-3049
Sébastien RivièreSorbonne Université, APHP, Service de Médecine Interne, Hopital Saint-Antoine, Paris, Île-de-France, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsSystemic sclerosis (SSc) is an autoimmune connective disease characterised by excessive extracellular matrix deposition and widespread skin and internal organ fibrosis including various cardiac manifestations. Heart involvement is one of the leading causes of death among patients with SSc. In this study, we aimed to assess the effect of various vasodilator treatments.

methodsWe used data from a national multicentric prospective study using the French SSc national database. We estimated the average treatment effect (ATE) of sildenafil, bosentan, angiotensin-converting enzyme (ACE) inhibitors and iloprost on diastolic dysfunction, altered ejection fraction <50% and pulmonary arterial hypertension (PAH) using a causal method, namely the longitudinal targeted minimum loss-based estimation, to adjust for confounding and informative censoring.

resultsWe included 1048 patients with available data regarding treatment. Regarding sildenafil analyses, the ATE on diastolic dysfunction at 3 years was -2.83% (95% CI -4.06; -1.60, p<0.00001), and the estimated ATE on altered ejection fraction <50% was -0.88% (95% CI -1.70; -0.05, p=0.037). We did not find a significative effect on PAH. Regarding bosentan, ACE inhibitors and iloprost, none of them neither showed a significant effect on diastolic dysfunction, altered ejection fraction <50% or PAH.

conclusionsUsing causal methods, our study is the first and largest suggesting that sildenafil might have benefits among SSc patients regarding diastolic dysfunction and altered ejection fraction occurrence. However, further studies assessing the effect of vasodilators on heart-related outcome among SSc patients are needed to confirm those exploratory results.

Indexed as

BosentanScleroderma, SystemicVasodilator AgentsAdultAgedAngiotensin-Converting Enzyme InhibitorsFemaleHumansIloprostMaleMiddle AgedProspective StudiesSildenafil CitrateStroke VolumeTreatment OutcomeAngiotensin-Converting Enzyme InhibitorsBosentanIloprostSildenafil CitrateVasodilator AgentsCardiovascular DiseasesMachine LearningSystemic Sclerosis

Identifiers

PMID39658051
PMCPMC11629012

What Socratic holds

Textmetadata
LicenceCC BY-NC
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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.