Pharmacological treatment of abdominal aortic aneurysm: a systematic review and network Meta-analysis
Objective:To identify potential therapeutic agents for abdominal aortic aneurysm (AAA) patients by conducting a network Meta-analysis (NMA) and systematic review.Methods:A literature search was conducted in PubMed, Embase, Web of Science, and Cochrane to identify randomized controlled trials (RCTs) on patients with AAA for further analysis. The primary outcome was AAA events, which were defined as AAA dilation or rupture. The surface under the cumulative ranking curve (SUCRA) probability values were applied to rank the drugs. The Bayesian framework was used in an NMA to investigate drugs that could prevent dilatation and rupture of AAA.Results:A total of 10 RCTs including 2234 patients with AAA were included. Patients under pharmacological therapies exhibited a comparable incidence of AAA events to those treated with placebo, with a pooled relative risk (RR) of 0.85 (95% confidence interval [CI]: 0.28-2.58), 1.24 (95%CI: 0.51-3.07), 0.98 (95%CI: 0.55-1.72), 2.39 (95%CI: 0.57-18.45), 1.21 (95%CI: 0.43-3.39), 1.22 (95%CI: 0.69-2.11), 0.80 (95%CI: 0.22-2.66), and 1.32 (95%CI: 0.47-3.83) for amlodipine, azithromycin, doxycycline, pemirolast, perindopril, propranolol, roxithromycin, and telmisartan, respectively. A total of 5 studies (1284 patients) reported adverse events associated with drug therapy. There was no significant difference in the risk of adverse events with doxycycline, pimirolast, and telmisartan compared with placebo, and the pooled RR values were 1.06 (95%CI: 0.95-1.18), 1.01 (95%CI: 0.88-1.17), and 1.07 (95%CI: 0.85-1.37), respectively.Conclusion:This NMA demonstrated that no drugs have a definitive therapeutic effect on AAA, and further prospective RCTs are still required.
万方数据
