• Arch Med Sci · Jan 2024

    Review

    Comparative tolerability of targeted therapies in pulmonary hypertension.

    • Magdalena Jasińska-Stroschein, Karolina Stawarczyk, Anna Stępień, and Daria Orszulak-Michalak.
    • Department of Biopharmacy, Medical University of Lodz, Lodz, Poland.
    • Arch Med Sci. 2024 Jan 1; 20 (1): 167188167-188.

    IntroductionThe objective of this study was to estimate the safety profile of pulmonary hypertension-specific therapies using placebo-controlled and active comparator trials.Material And MethodsThe search corpus comprised Medline, Scopus, Embase and Clinical Trials databases. A systematic review and meta-analysis was performed to assess the relative risk of severe events and discontinuations as well as of adverse drug reactions (ADRs) classified into 26 categories and 21 subcategories defined by the Medical Dictionary for Regulatory Activities (MedRA).ResultsPulmonary hypertension-specific therapies had the greatest effect on such events as flushing and headache as well as jaw pain, limb pain and myalgia or gastrointestinal disorders. The relative risk for ADRs in patients receiving monotherapy (vs. placebo/supportive therapies) and combined regimens (vs. monotherapy) was significantly increased. The risk of cessation for the combined regimen was slightly higher (Qinter-group, p = 0.0778). Such ADRs as blood and lymphatic system disorders with the anemia subgroup, gastrointestinal disorders with diarrhea and nausea subgroups, respiratory and thoracic diseases or nervous system disorders with headache tended to occur more often in combination regimens as compared to monotherapy.ConclusionsAbout half of the main categories and subcategories of adverse reactions according to MedRA were associated with a relatively high frequency and hazard ratio. Their risk can be increased when combination regimens are used, especially.Copyright: © 2020 Termedia & Banach.

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