Comparative Efficacy and Safety of Targeted Therapies for Chronic Thromboembolic Pulmonary Hypertension: A Systematic Review and Network Meta-Analysis

Table 3

Results of the efficacy and safety of the PAH-targeted drugs according to the network meta-analysis.

6MWD (meters)	Riociguat
	3.40 (−28.98, 35.78)	Treprostinil
	11.00 (−26.11, 48.11)	7.60 (−31.54, 46.74)	Macitentan
	23.50 (−23.81, 70.81)	20.10 (−28.82, 69.02)	12.50 (−39.67, 64.67)	Ambrisentan
	27.50 (−91.34, 146.34)	24.10 (−95.39, 143.59)	16.50 (−104.36, 137.36)	4.00 (−120.37, 128.37)	Sildenafil
	39.41 (7.97, 70.85)	36.01 (2.19, 69.83)	28.41 (−9.96, 66.78)	15.91 (−32.39, 64.22)	11.91 (−107.33, 131.15)	Bosentan
	45.00 (23.87, 66.13)	41.60 (17.07, 66.13)	34.00 (3.50, 64.50)	21.50 (−20.83, 63.83)	17.50 (−99.44, 134.44)	5.59 (−17.69, 28.87)	Placebo
NYHA/WHO FC	Sildenafil
	3.52 (0.14, 89.04)	Treprostinil
	4.42 (0.15, 128.79)	1.25 (0.25, 6.29)	Bosentan
	6.14 (0.26, 146.24)	1.74 (0.56, 5.39)	1.39 (0.31, 6.17)	Riociguat
	14.80 (0.56, 392.81)	4.20 (1.03, 17.14)	3.35 (0.61, 18.51)	2.41 (0.68, 8.53)	Macitentan
	17.18 (0.78, 380.84)	4.88 (1.96, 12.11)	3.89 (1.03, 14.73)	2.80 (1.43, 5.46)	1.16 (0.40, 3.40)	Placebo
BNP/NT-pro BNP (pg/ml)	Sildenafil
	0.19 (−0.81, 1.18)	Treprostinil
	0.33 (−0.62, 1.28)	0.14 (−0.37, 0.66)	Bosentan
	0.03 (−0.92, 0.98)	−0.16 (−0.66, 0.34)	−0.30 (−0.72, 0.11)	Riociguat
	0.07 (−0.94, 1.08)	−0.12 (−0.73, 0.49)	−0.26 (−0.80, 0.28)	0.04 (−0.49, 0.57)	Macitentan
	−0.19 (−1.10, 0.71)	−0.38 (−0.79, 0.03)	−0.53 (−0.83, −0.22)	−0.22 (−0.50, 0.06)	−0.26 (−0.71, 0.18)	Placebo
PVR (dynes/sec/cm−5)	Treprostinil
	−38.20 (−180.11, 103.71)	Riociguat
	−90.20 (−607.72, 427.32)	−52.00 (−559.79, 455.79)	Sildenafil
	−111.20 (−258.85, 36.45)	−73.00 (−181.75, 35.75)	−21.00 (−530.43, 488.43)	Bosentan
	−120.20 (−255.35, 14.95)	−82.00 (−173.05, 9.05)	−30.00 (−535.94, 475.94)	−9.00 (−108.77, 90.77)	Iloprost
	−167.20 (−375.21, 40.81)	−129.00 (−311.47, 53.47)	−77.00 (−607.08, 453.08)	−56.00 (−242.97, 130.97)	−47.00 (−224.26, 130.26)	Macitentan
	−287.20 (−409.90, −164.50)	−249.00 (−320.29, −177.71)	−197.00 (−699.76, 305.76)	−176.00 (−258.13, −93.87)	−167.00 (−223.65, −110.35)	−120.00 (−287.96, 47.96)	Placebo
Clinical worsening	Treprostinil
	1.29 (0.24, 6.98)	Riociguat
			Sildenafil
	0.83 (0.14, 4.99)	0.65 (0.09, 4.71)		Bosentan
					Iloprost
	2.04 (0.30, 14.12)	1.58 (0.19, 13.16)		2.45 (0.27, 22.11)		Macitentan
	0.51 (0.18, 1.41)	0.39 (0.10, 1.50)		0.61 (0.14, 2.64)		0.25 (0.05, 1.28)	Placebo

Comparisons should be read from the left (active agent) to the right (comparator agent or placebo). Change of 6MWD, with WMD > 0 indicating higher improvement. The change in BNP/NT-proBNP, with SMD < 0 supporting the intervention. NYHA/WHO FC improvement is defined as an increase in NYHA/WHO FC by at least one level, with OR > 1 favouring effective treatment. Clinical worsening, with OR < 1 corresponding to the active agent. PVR change, with WMD < 0 denoting higher amelioration. Bold numbers are statistically significant. Numbers in parentheses indicate 95% CI.