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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
Affiliation:
Department of Paediatrics, Peking University First Hospital, Beijing 100034, China
Bowen Xu
Affiliation:
Department of Paediatrics, Peking University First Hospital, Beijing 100034, China
Jichen Lv
Affiliation:
Department of Paediatrics, Peking University First Hospital, Beijing 100034, China
Zhijian Wang
Affiliation:
Department of Paediatrics, Peking University First Hospital, Beijing 100034, China
Junbao Du*
Affiliation:
Department of Paediatrics, Peking University First Hospital, Beijing 100034, China
*Corresponding
Author for correspondence: Professor Junbao Du, Department of Paediatrics, Peking University First Hospital, Xi-An Men Street No. 1, West District, Beijing 100034, China. Tel: +8610-83573238; Fax: +8610-66530532. E-mail: junbaodu1@126.com

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.

Type
Original Article
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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