Meta-analysis supports ambrisentan efficacy

By Eleanor McDermid, Senior medwireNews Reporter

A meta-analysis supports the efficacy of ambrisentan in patients with pulmonary arterial hypertension (PAH).

However, Xue-Qin Li (Zhongshan Hospital of Sun Yat-Sen University, China) and co-researchers emphasise that there is relatively little data available on the efficacy and safety of ambrisentan. The team searched for case–control and cohort studies addressing the issue, and found just eight studies with 172 patients.

“[F]urther studies with larger sample sizes are essential to validate our findings”, they write in Clinical Therapeutics.

Five of the included studies were conducted in Asia and three in the USA, and they had follow-up times ranging between 12 and 80 weeks. The studies were highly heterogeneous, but there was no evidence of publication bias.

In pooled analyses, ambrisentan treatment resulted in significant improvements in patients’ 6-minute walk distance, versus baseline or controls, with a standard mean difference (SMD) of 0.56.

Likewise, ambrisentan treatment led to overall improvements in patients’ mean pulmonary arterial pressure, systolic pulmonary artery pressure, and brain natriuretic peptide levels, at SMDs of 1.23, 0.69 and 0.34, respectively.

“Our meta-analysis provided strong evidence that ambrisentan improves exercise tolerance and cardiac function in [PAH] patients”, say the researchers.

Li et al note that, besides improving the function of PAH patients, ambrisentan is simple to take, with just once-daily administration needed, has a limited drug–drug interaction profile and is associated with a low risk of liver enzyme increases.

However, they note that some side effects associated with ambrisentan, such as angioedema, infection, sinusitis, flushing and nasal congestion, may reduce patients’ tolerance of the drug.

“Therefore, [PAH] patients are strongly advised to exercise caution when treated with ambrisentan”, the team concludes.

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