Animal Models and Experimental Medicine >

2024 , Vol. 7 >Issue 1: 56 - 70

DOI: https://doi.org/10.1002/ame2.12347

Comparing the efficacy and safety of low, medium, and high dosages of selexipag for treating pulmonary hypertension: A systematic review and meta-analysis

  • Shang Wang 1 ,
  • Yi Yan 2 ,
  • Jian Zhang 3 ,
  • Ping Yuan 1 ,
  • Ci-Jun Luo 1 ,
  • Hong-Ling Qiu 1 ,
  • Hui-Ting Li 1 ,
  • Jian Xu 1 ,
  • Lan Wang , 1 ,
  • Tian-Lan Li , 4 ,
  • Rong Jiang , 1
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  • 1. Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
  • 2. Heart Center and Shanghai Institute of Pediatric Congenital Heart Disease, Shanghai Children’s Medical Center, National Children’s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
  • 3. Department of Respiratory and Critical Care Medicine, The 416 Hospital of Nuclear Industry, The Second Affiliated Hospital of Chengdu Medical College, Chengdu, China
  • 4. Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, China

Received date: 04 Apr 2023

Accepted date: 08 Aug 2023

Copyright

2023 2023 The Authors. Animal Models and Experimental Medicine published by John Wiley & Sons Australia, Ltd on behalf of The Chinese Association for Laboratory Animal Sciences.
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Abstract

Background: The maintenance dosage of selexipag is categorized as low, medium or high. In order to assess the efficacy and safety of different dosages of selexipag for the risk stratification of pulmonary arterial hypertension (PAH), we performed a systematic review and meta-analysis.

Methods: Studies assessing PAH risk stratification indices, such as the World Health Organization functional class (WHO-FC), six-minute walk distance (6MWD), N-terminal pro-B-type natriuretic peptide (NT-proBNP) level, right atrial pressure (RAP), cardiac index (CI) and mixed venous oxygen saturation (SvO2), were included.

Results: Thirteen studies were included. Selexipag led to improvements in the 6MWD (MD: 24.20 m, 95% CI: 10.74-37.67), NT-proBNP (SMD: −0.41, 95% CI: −0.79-0.04), CI (MD: 0.47 L/min/m2, 95% CI: 0.17-0.77) and WHO-FC (OR: 0.564, 95% CI: 0.457-0.697). Subgroup analysis demonstrated that all three dosages improved the 6MWD. A moderate dosage led to improvements in the CI (MD: 0.30 L/min/m2, 95% CI: 0.15-0.46) and WHO-FC (OR: 0.589, 95% CI: 0.376-0.922). Within 6 months of treatment, only the WHO-FC and CI were significantly improved (OR: 0.614, 95% CI: 0.380-0.993; MD: 0.30 L/min/m2, 95% CI: 0.16-0.45, respectively). More than 6 months of treatment significantly improved the 6MWD, WHO-FC and NT-proBNP (MD: 40.87 m, 95% CI: 10.97-70.77; OR: 0.557, 95% CI: 0.440-0.705; SMD: −0.61, 95% CI: −1.17-0.05, respectively).

Conclusions: Low, medium, and high dosages of selexipag all exhibited good effects. When treatment lasted for more than 6 months, selexipag exerted obvious effects, even in the low-dosage group. This finding is important for guiding individualized treatments.

Key words： individualized treatments; meta-analysis; prostacyclin receptor agonist; risk stratification; systematic review

Cite this article

Shang Wang, Yi Yan, Jian Zhang, Ping Yuan, Ci-Jun Luo, Hong-Ling Qiu, Hui-Ting Li, Jian Xu, Lan Wang, Tian-Lan Li, Rong Jiang. Comparing the efficacy and safety of low, medium, and high dosages of selexipag for treating pulmonary hypertension: A systematic review and meta-analysis[J]. Animal Models and Experimental Medicine, 2024, 7(1): 56-70. DOI: 10.1002/ame2.12347

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