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Effects of phosphodiesterase-5 inhibitors in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis
Isa, Nafeesah Mudhafar, Durrah Ju, Chengsheng Man, Kenneth K. C. Lau, Wallis C. Y. Cheng, Lok Yin Wei, Li
Isa, Nafeesah
Mudhafar, Durrah
Ju, Chengsheng
Man, Kenneth K. C.
Lau, Wallis C. Y.
Cheng, Lok Yin
Wei, Li
Abstract
Chronic obstructive pulmonary disease (COPD) is a major burden of healthcare worldwide. We aimed to determine the effects of PDE-5 inhibitors on clinical outcomes and haemodynamic parameters in patients with COPD. A PROSPERO-registered systematic review and meta-analysis (identification number CRD42021227578) were performed to analyse the effects of PDE-5 inhibitors in patients with COPD. Data were sourced from MEDLINE, EMBASE, Cochrane Register of Controlled Trials and "ClinicalTrials.gov." Randomised controlled trials (RCTs) comparing PDE-5 inhibitors with control in patients with COPD were included. Quality assessment was carried out using the Cochrane Collaboration's tool for assessing the risk of bias in randomised trials. The pooled mean difference of 6-minute walk distance (6MWD) and mean pulmonary arterial pressure based on inverse variance estimation were analysed with a fixed-effect model or random-effects model meta-analysis. Nine RCTs involving 414 patients were included in the review. There was no significant difference in 6MWD (mean difference = 22.06 metres, 95% confidence interval (CI), -5.80 to 49.91). However, there was a statistically significant difference between PDE-5 inhibitor and control groups in mean pulmonary artery pressure (mean difference = -3.83 mmHg, 95% CI, -5.93 to -1.74). Headaches were the most common adverse event, occurring significantly in the PDE-5 inhibitor intervention group (odds ratio 3.83, 95% CI, 1.49 to 9.86). This systematic review indicates that PDE-5 inhibitors do not improve exercise capacity despite some possible improvements in haemodynamic parameters in COPD patients.
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Date
2022
Type
Article
Subject
Respiratory medicine, Pharmacology
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Citation
Isa N, Mudhafar D, Ju C, Man KKC, Lau WCY, Cheng LY, Wei L. Effects of Phosphodiesterase-5 Inhibitors in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. COPD. 2022;19(1):300-308. doi: 10.1080/15412555.2022.2067525.
Journal / Source Title
COPD
DOI
10.1080/15412555.2022.2067525
PMID
35723554
Publisher
Taylor and Francis Group
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