Publicação
Balloon pulmonary angioplasty and riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic review
| Resumo: | Background: No systematic review has been published comparing the effectiveness and safety of balloon pulmonary angioplasty (BPA) and riociguat in patients with chronic thromboembolic pulmonary hypertension (CTEPH) across studies that evaluate both treatment methods. Methods: A literature search was conducted using PubMed, ScienceDirect, and Elsevier. Clinical, functional, and hemodynamic effectiveness criteria were analysed, as well as complications related to both interventions. Results: Five studies were reviewed, including randomized clinical trials and observational studies, comprising 184 patients who underwent riociguat and BPA, 94 patients who underwent BPA alone, and 79 who underwent riociguat alone. Patients receiving combination therapy demonstrated a more significant improvement in WHO-FC, PVR, and CO (≈1.13 L/min) than monotherapy (BPA: ≈0.45 L/min and riociguat: ≈0.84 L/min). Regarding the 6MWD, patients who started with Riociguat before combination therapy showed a greater improvement (≈78 m) than those on monotherapy (BPA: ≈46.9 m and riociguat: ≈38.2 m). The reduction in mPAP was greater in patients treated with BPA alone (≈-17.6 mmHg) compared to riociguat alone (≈-5.4 mmHg) or combination therapy (≈-12.2 mmHg). In the BPA group, the rate of life-threatening complications was very low, with haemoptysis or pulmonary haemorrhage being the most common adverse events (15%-44%). In the riociguat group, dizziness, headaches, gastrointestinal reflux, vomiting, and nausea were reported (15%-23%). Among patients undergoing both treatments, the vascular injury rate was <11 %, with the most common adverse event being the need for non-invasive ventilation (30 %). Conclusions: Combination therapy appears to be more effective than monotherapy, without being associated with major adverse events in patients diagnosed with CTEPH. |
|---|---|
| Autores principais: | Araújo, Patrícia |
| Outros Autores: | Calé, Rita; Pereira, Ernesto; Ferreira, Filipa; Alegria, Sofia; Pereira, Hélder; Coelho, André |
| Assunto: | Balloon pulmonary angioplasty Chronic thromboembolic pulmonary hypertension Effectiveness Pulmonary vasodilator therapy Safety |
| Ano: | 2025 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso embargado |
| Instituição associada: | Universidade Politécnica de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório Científico da Universidade Politécnica de Lisboa |
| _version_ | 1880398433277181952 |
|---|---|
| author | Araújo, Patrícia |
| author2 | Calé, Rita Pereira, Ernesto Ferreira, Filipa Alegria, Sofia Pereira, Hélder Coelho, André |
| author2_role | author author author author author author |
| author_facet | Araújo, Patrícia Calé, Rita Pereira, Ernesto Ferreira, Filipa Alegria, Sofia Pereira, Hélder Coelho, André |
| author_role | author |
| contributor_name_str_mv | RCIPL |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Araújo, Patrícia\"},{\"Person.name\":\"Calé, Rita\"},{\"Person.name\":\"Pereira, Ernesto\"},{\"Person.name\":\"Ferreira, Filipa\"},{\"Person.name\":\"Alegria, Sofia\"},{\"Person.name\":\"Pereira, Hélder\"},{\"Person.name\":\"Coelho, André\",\"Person.identifier.cienciaID\":\"291E-1AC6-86FA\",\"Person.identifier.orcid\":\"0000-0003-1872-8131\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | RCIPL |
| datacite.creators.creator.creatorName.fl_str_mv | Araújo, Patrícia Calé, Rita Pereira, Ernesto Ferreira, Filipa Alegria, Sofia Pereira, Hélder Coelho, André |
| datacite.date.Accepted.fl_str_mv | 2025-05-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2025-06-04T13:51:30Z |
| datacite.date.embargoed.fl_str_mv | 2025-06-04T13:51:30Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_f1cf |
| datacite.subjects.subject.fl_str_mv | Balloon pulmonary angioplasty Chronic thromboembolic pulmonary hypertension Effectiveness Pulmonary vasodilator therapy Safety |
| datacite.titles.title.fl_str_mv | Balloon pulmonary angioplasty and riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic review |
| dc.contributor.none.fl_str_mv | RCIPL |
| dc.creator.none.fl_str_mv | Araújo, Patrícia Calé, Rita Pereira, Ernesto Ferreira, Filipa Alegria, Sofia Pereira, Hélder Coelho, André |
| dc.date.Accepted.fl_str_mv | 2025-05-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2025-06-04T13:51:30Z |
| dc.date.embargoed.fl_str_mv | 2025-06-04T13:51:30Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10400.21/21901 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Elsevier |
| dc.rights.cclincense.fl_str_mv | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_f1cf |
| dc.subject.none.fl_str_mv | Balloon pulmonary angioplasty Chronic thromboembolic pulmonary hypertension Effectiveness Pulmonary vasodilator therapy Safety |
| dc.title.fl_str_mv | Balloon pulmonary angioplasty and riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic review |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | Background: No systematic review has been published comparing the effectiveness and safety of balloon pulmonary angioplasty (BPA) and riociguat in patients with chronic thromboembolic pulmonary hypertension (CTEPH) across studies that evaluate both treatment methods. Methods: A literature search was conducted using PubMed, ScienceDirect, and Elsevier. Clinical, functional, and hemodynamic effectiveness criteria were analysed, as well as complications related to both interventions. Results: Five studies were reviewed, including randomized clinical trials and observational studies, comprising 184 patients who underwent riociguat and BPA, 94 patients who underwent BPA alone, and 79 who underwent riociguat alone. Patients receiving combination therapy demonstrated a more significant improvement in WHO-FC, PVR, and CO (≈1.13 L/min) than monotherapy (BPA: ≈0.45 L/min and riociguat: ≈0.84 L/min). Regarding the 6MWD, patients who started with Riociguat before combination therapy showed a greater improvement (≈78 m) than those on monotherapy (BPA: ≈46.9 m and riociguat: ≈38.2 m). The reduction in mPAP was greater in patients treated with BPA alone (≈-17.6 mmHg) compared to riociguat alone (≈-5.4 mmHg) or combination therapy (≈-12.2 mmHg). In the BPA group, the rate of life-threatening complications was very low, with haemoptysis or pulmonary haemorrhage being the most common adverse events (15%-44%). In the riociguat group, dizziness, headaches, gastrointestinal reflux, vomiting, and nausea were reported (15%-23%). Among patients undergoing both treatments, the vascular injury rate was <11 %, with the most common adverse event being the need for non-invasive ventilation (30 %). Conclusions: Combination therapy appears to be more effective than monotherapy, without being associated with major adverse events in patients diagnosed with CTEPH. |
| dirty | 0 |
| eu_rights_str_mv | embargoedAccess |
| format | article |
| fulltext.url.fl_str_mv | https://repositorio.ipl.pt/bitstreams/9513304c-6a72-435b-8806-e3071db4d73f/download |
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| identifier.url.fl_str_mv | http://hdl.handle.net/10400.21/21901 |
| inst_facet_str | urn:organizationAcronym:ipl{{{_:::_}}}Universidade Politécnica de Lisboa |
| instacron_str | ipl |
| institution | Universidade Politécnica de Lisboa |
| instname_str | Universidade Politécnica de Lisboa |
| language | eng |
| network_acronym_str | ripl |
| network_name_str | Repositório Científico da Universidade Politécnica de Lisboa |
| oai_identifier_str | oai:repositorio.ipl.pt:10400.21/21901 |
| organization_str_mv | urn:organizationAcronym:ipl |
| person_str_mv | Araújo, Patrícia Calé, Rita Pereira, Ernesto Ferreira, Filipa Alegria, Sofia Pereira, Hélder Coelho, André Coelho, André https://www.ciencia-id.pt/291E-1AC6-86FA 291E-1AC6-86FA http://orcid.org/0000-0003-1872-8131 0000-0003-1872-8131 |
| publishDate | 2025 |
| publisher.none.fl_str_mv | Elsevier |
| repo_facet_str | urn:repositoryAcronym:ripl{{{_:::_}}}Repositório Científico da Universidade Politécnica de Lisboa |
| reponame_str | Repositório Científico da Universidade Politécnica de Lisboa |
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| spelling | engElsevierengBackground: No systematic review has been published comparing the effectiveness and safety of balloon pulmonary angioplasty (BPA) and riociguat in patients with chronic thromboembolic pulmonary hypertension (CTEPH) across studies that evaluate both treatment methods. Methods: A literature search was conducted using PubMed, ScienceDirect, and Elsevier. Clinical, functional, and hemodynamic effectiveness criteria were analysed, as well as complications related to both interventions. Results: Five studies were reviewed, including randomized clinical trials and observational studies, comprising 184 patients who underwent riociguat and BPA, 94 patients who underwent BPA alone, and 79 who underwent riociguat alone. Patients receiving combination therapy demonstrated a more significant improvement in WHO-FC, PVR, and CO (≈1.13 L/min) than monotherapy (BPA: ≈0.45 L/min and riociguat: ≈0.84 L/min). Regarding the 6MWD, patients who started with Riociguat before combination therapy showed a greater improvement (≈78 m) than those on monotherapy (BPA: ≈46.9 m and riociguat: ≈38.2 m). The reduction in mPAP was greater in patients treated with BPA alone (≈-17.6 mmHg) compared to riociguat alone (≈-5.4 mmHg) or combination therapy (≈-12.2 mmHg). In the BPA group, the rate of life-threatening complications was very low, with haemoptysis or pulmonary haemorrhage being the most common adverse events (15%-44%). In the riociguat group, dizziness, headaches, gastrointestinal reflux, vomiting, and nausea were reported (15%-23%). Among patients undergoing both treatments, the vascular injury rate was <11 %, with the most common adverse event being the need for non-invasive ventilation (30 %). Conclusions: Combination therapy appears to be more effective than monotherapy, without being associated with major adverse events in patients diagnosed with CTEPH.application/pdfengBalloon pulmonary angioplasty and riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic reviewAraújo, PatríciaCalé, RitaPereira, ErnestoFerreira, FilipaAlegria, SofiaPereira, HélderPersonalCoelho, AndréDSpacehttp://dspace.org/items/e00e9fd8-697d-4e70-acd3-e5a5169360edDSpacehttp://dspace.org/items/e00e9fd8-697d-4e70-acd3-e5a5169360edFerreira Ramos CoelhoAndré FilipeCiência IDhttps://www.ciencia-id.pt291E-1AC6-86FAORCIDhttp://orcid.org0000-0003-1872-8131HostingInstitutionOrganizationalRCIPLe-mailmailto:rcaap@sp.ipl.ptrcaap@sp.ipl.ptISSNIsPartOf0954-6111DOIIsPartOf10.1016/j.rmed.2025.1081542025-06-04T13:51:30Z2025-052025-05-01T00:00:00ZHandlehttp://hdl.handle.net/10400.21/21901http://purl.org/coar/access_right/c_f1cfembargoed accessBalloon pulmonary angioplastyChronic thromboembolic pulmonary hypertensionEffectivenessPulmonary vasodilator therapySafety662347 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal article2025-05http://creativecommons.org/licenses/by-nc-nd/4.0/http://purl.org/coar/access_right/c_f1cfapplication/pdffulltexthttps://repositorio.ipl.pt/bitstreams/9513304c-6a72-435b-8806-e3071db4d73f/downloadRespiratory Medicine244108154 |
| spellingShingle | Balloon pulmonary angioplasty and riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic review Araújo, Patrícia Balloon pulmonary angioplasty Chronic thromboembolic pulmonary hypertension Effectiveness Pulmonary vasodilator therapy Safety |
| status | SINGLETON |
| subject.fl_str_mv | Balloon pulmonary angioplasty Chronic thromboembolic pulmonary hypertension Effectiveness Pulmonary vasodilator therapy Safety |
| title | Balloon pulmonary angioplasty and riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic review |
| title_full | Balloon pulmonary angioplasty and riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic review |
| title_fullStr | Balloon pulmonary angioplasty and riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic review |
| title_full_unstemmed | Balloon pulmonary angioplasty and riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic review |
| title_short | Balloon pulmonary angioplasty and riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic review |
| title_sort | Balloon pulmonary angioplasty and riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic review |
| topic | Balloon pulmonary angioplasty Chronic thromboembolic pulmonary hypertension Effectiveness Pulmonary vasodilator therapy Safety |
| topic_facet | Balloon pulmonary angioplasty Chronic thromboembolic pulmonary hypertension Effectiveness Pulmonary vasodilator therapy Safety |
| url | http://hdl.handle.net/10400.21/21901 |
| visible | 1 |
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