PMID- 22691882
OWN - NLM
STAT- MEDLINE
DCOM- 20130319
LR  - 20141120
IS  - 1533-4023 (Electronic)
IS  - 0160-2446 (Linking)
VI  - 60
IP  - 4
DP  - 2012 Oct
TI  - Combination therapy improves exercise capacity and reduces risk of clinical 
      worsening in patients with pulmonary arterial hypertension: a meta-analysis.
PG  - 342-6
LID - 10.1097/FJC.0b013e318262a793 [doi]
AB  - BACKGROUND: Clinical studies on combination therapy in patients with pulmonary 
      arterial hypertension (PAH) revealed mixed results. AIMS: The aim of the present 
      meta-analysis was to evaluate the effect of combination therapy on exercise 
      capacity [measured with 6-minute walk distance (6MWD)] and clinical worsening in 
      PAH patients. METHODS: We identified trials of importance from the Cochrane 
      Library, EMBASE, and PUBMED databases, reviews, and reference lists of relevant 
      articles. We calculated risk ratios for dichotomous data and weighted mean 
      differences, with 95% confidence intervals (CIs), for net changes in 6MWD. 
      RESULTS: Seven trials with a total of 768 patients (386 patients in the 
      combination treatment group and 382 patients in the monotherapy group) were 
      included in the meta-analysis. Compared with the monotherapy group, combination 
      therapy increased 6MWD by 21.59 meters (weighted mean difference 21.59 m, 95% CI 
      of 13.25-29.93; P < 0.001) and reduced the risk of clinical worsening (risk 
      ratio: 0.43, 95% CI: 0.26-0.72, P = 0.001). For both outcomes, no significant 
      heterogeneity and publication bias were found. CONCLUSION: Compared with 
      monotherapy, combination therapy improves exercise capacity and reduces the risk 
      of clinical worsening in PAH patients. In future studies, more large randomized 
      controlled trials should be designed to adequately assess the efficacy and safety 
      of combination therapy.
FAU - Zhu, Bing
AU  - Zhu B
AD  - Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China. 
      zhubing301@sina.com
FAU - Wang, Liang
AU  - Wang L
FAU - Sun, Lan
AU  - Sun L
FAU - Cao, Ruihua
AU  - Cao R
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - J Cardiovasc Pharmacol
JT  - Journal of cardiovascular pharmacology
JID - 7902492
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Endothelin Receptor Antagonists)
RN  - 0 (Phosphodiesterase 5 Inhibitors)
RN  - 0 (Prostaglandins)
SB  - IM
MH  - Antihypertensive Agents/administration & dosage/pharmacology/*therapeutic use
MH  - Drug Therapy, Combination
MH  - Endothelin Receptor Antagonists
MH  - Exercise Tolerance/*drug effects
MH  - Familial Primary Pulmonary Hypertension
MH  - Humans
MH  - Hypertension, Pulmonary/*drug therapy/physiopathology
MH  - Phosphodiesterase 5 Inhibitors/administration & dosage/pharmacology/therapeutic 
      use
MH  - Prostaglandins/administration & dosage/pharmacology/therapeutic use
EDAT- 2012/06/14 06:00
MHDA- 2013/03/21 06:00
CRDT- 2012/06/14 06:00
PHST- 2012/06/14 06:00 [entrez]
PHST- 2012/06/14 06:00 [pubmed]
PHST- 2013/03/21 06:00 [medline]
AID - 10.1097/FJC.0b013e318262a793 [doi]
PST - ppublish
SO  - J Cardiovasc Pharmacol. 2012 Oct;60(4):342-6. doi: 10.1097/FJC.0b013e318262a793.