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Safety and effect of sildenafil on treating paediatric pulmonary arterial hypertension: a meta-analysis on the randomised controlled trials

Published online by Cambridge University Press:  20 October 2020

Qingyou Zhang ,
Bowen Xu Open the ORCID record for Bowen Xu [Opens in a new window] ,
Jichen Lv ,
Zhijian Wang  and
Junbao Du
Qingyou Zhang
Affiliation:
Department of Paediatrics, Peking University First Hospital, Beijing100034, China
Bowen Xu
Affiliation:
Department of Paediatrics, Peking University First Hospital, Beijing100034, China
Jichen Lv
Affiliation:
Department of Paediatrics, Peking University First Hospital, Beijing100034, China
Zhijian Wang
Affiliation:
Department of Paediatrics, Peking University First Hospital, Beijing100034, China
Junbao Du*
Affiliation:
Department of Paediatrics, Peking University First Hospital, Beijing100034, China
*
Author for correspondence: Professor Junbao Du, Department of Paediatrics, Peking University First Hospital, Xi-An Men Street No. 1, West District, Beijing100034, China. Tel: +8610-83573238; Fax: +8610-66530532. E-mail: junbaodu1@126.com
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Abstract

Background:

Efficacy of sildenafil in treating paediatric pulmonary arterial hypertension is controversial. This systematic review aimed to explore the safety and effect of sildenafil on treating paediatric pulmonary arterial hypertension (PAH) through meta-analysis.

Methods and results:

In this study, the electronic databases, including the Cochran Library database, EMBASE, and MEDLINE were systemically retrieved to identify the related randomised controlled trials (RCTs). Two reviewers had independently completed study selection, data collection, and assessment of the bias risk. Amongst 938 articles researched according to our retrieval strategy, 15 papers that involved 673 cases had been screened. Relative to control group, the sildenafil group had markedly reduced mortality (RR = 0.25, 95% CI: 0.12–0.51; p < 0.0001), but difference within the mortality was not statistically significant between high- and low-dose sildenafil groups (p = 0.152). Nonetheless, difference of the mean pulmonary arterial pressure between sildenafil as well as control group was of no statistical significance. Differences in the length of hospital stay and the incidences of pulmonary hypertensive crisis between children with PAH and controls were of no statistical significance. However, the summary estimate favoured that sildenafil reduced the duration of mechanical ventilation time, as well as the length of ICU stay and inotropic support.

Conclusions:

Sildenafil therapy reduces the mortality of PAH patients, but its effects on the haemodynamic outcomes and other clinical outcomes are still unclear.

Keywords

Sildenafilpaediatric pulmonary arterial hypertensioneffectsafetymortalitymeta-analysis
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 12 , December 2020 , pp. 1882 - 1889
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Qingyou Zhang and Bowen Xu contributed to this work equally.

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