The efficacy of pharmacotherapy for decreasing the expansion rate of abdominal aortic aneurysms: a systematic review and meta-analysis.

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State: Public
Version: Final published version
Serval ID
serval:BIB_A89663BA7A63
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The efficacy of pharmacotherapy for decreasing the expansion rate of abdominal aortic aneurysms: a systematic review and meta-analysis.
Journal
PloS One
Author(s)
Guessous Idris, Periard Daniel, Lorenzetti Diane, Cornuz Jacques, Ghali William A.
ISSN
1932-6203[electronic]
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
3
Number
3
Pages
1895
Language
english
Notes
Publication types: Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Review Publication Status: epublish
Abstract
BACKGROUND: Pharmacotherapy may represent a potential means to limit the expansion rate of abdominal aortic aneurysms (AAAs). Studies evaluating the efficacy of different pharmacological agents to slow down human AAA-expansion rates have been performed, but they have never been systematically reviewed or summarized. METHODS AND FINDINGS: Two independent reviewers identified studies and selected randomized trials and prospective cohort studies comparing the growth rate of AAA in patients with pharmacotherapy vs. no pharmacotherapy. We extracted information on study interventions, baseline characteristics, methodological quality, and AAA growth rate differences (in mm/year). Fourteen prospective studies met eligibility criteria. Five cohort studies raised the possibility of benefit of beta-blockers [pooled growth rate difference: -0.62 mm/year, (95%CI, -1.00 to -0.24)], but this was not confirmed in three beta-blocker RCTs [pooled RCT growth rate difference: -0.05 mm/year (-0.16 to 0.05)]. Statins have been evaluated in two cohort studies that yield a pooled growth rate difference of -2.97 (-5.83 to -0.11). Doxycycline and roxithromycin have been evaluated in two RCTs that suggest possible benefit [pooled RCT growth rate difference: -1.32 mm/year (-2.89 to 0.25)]. Studies assessing NSAIDs, diuretics, calcium channel blockers and ACE inhibitors, meanwhile, did not find statistically significant differences. CONCLUSIONS: Beta-blockers do not appear to significantly reduce the growth rate of AAAs. Statins and other anti-inflammatory agents appear to hold promise for decreasing the expansion rate of AAA, but need further evaluation before definitive recommendations can be made.
Keywords
Adrenergic beta-Antagonists/therapeutic use, Aortic Aneurysm, Abdominal/drug therapy, Aortic Aneurysm, Abdominal/pathology, Cohort Studies, Doxycycline/therapeutic use, Humans, Roxithromycin/therapeutic use
Pubmed
Web of science
Open Access
Yes
Create date
29/01/2009 22:14
Last modification date
20/08/2019 15:13
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