ReviewFrontiers in pharmacology2025
Comparative efficacy of pharmacological agents on abdominal aortic aneurysm growth rate: a systematic review and network meta-analysis.
Review in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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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.
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Authors and funding
5 authors.
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Abstract
Background: Abdominal aortic aneurysm (AAA) progression lacks proven medications. This study aimed to indirectly compare common drugs' effects on AAA growth rate using a network meta-analysis (NMA) of randomized controlled trials (RCTs) and cohort studies, assessing the reliability of evidence. Methods: We systematically searched the Cochrane Library, Embase, Web of Science, and PubMed until 5 June 2025. A Bayesian NMA synthesized direct and indirect evidence on drug effects on AAA growth rate, using standardized mean differences (SMD) with credible intervals (CrI). Cohort study results were analyzed separately. Results: After screening, 11 RCTs (2,135 subjects) and 13 cohort studies were included. Pooled RCT results showed roxithromycin significantly reduced AAA growth (SMD [95% CrI]: 0.39 [-0.69 to -0.10]). Roxithromycin also demonstrated advantages over amlodipine and doxycycline in indirect comparisons. Propranolol, perindopril, metformin, azithromycin, and ticagrelor showed no significant benefits. Cohort studies linked slower growth to statins and glucose-lowering drugs (insulin, metformin). Conclusion: Roxithromycin, statins, and metformin show promise for potentially limiting AAA expansion. However, findings are constrained by methodological limitations (study design, sample size), necessitating future validation via high-quality RCTs.
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