奥美沙坦/氨氯地平复方制剂与缬沙坦/氨氯地平复方制剂治疗原发性高血压的网状meta分析

Fixed-dose-combinations of Olmesartan/Amlodipine and Valsartan/Amlodipine for Treatment of Essential Hypertension: A Network Meta-analysis

关键词:  奥美沙坦  缬沙坦  氨氯地平  复方制剂  网状meta分析

Key words:  olmesartan  valsartan  amlodipine  fixed-dose combination  network meta-analysis

摘要:

目的 采用网状meta分析评价奥美沙坦/氨氯地平复方制剂与缬沙坦/氨氯地平复方制剂治疗原发性高血压人群的效果。方法 检索数据库PubMed、万方、中国知网，根据纳入排除标准进行文献筛选，获得相关的临床随机对照试验。使用《Cochrane系统评价员手册》对文献进行风险偏倚评估。提取纳入研究信息，使用R3.4.3软件中的gemtc程序包、ITC软件进行网状meta分析及间接比较。结果 最终纳入9篇文献，总共纳入3 137例原发性高血压患者。奥美沙坦/氨氯地平复方制剂在收缩压的降压效果上优于缬沙坦/氨氯地平复方制剂[MD=3.2 mmHg，95%CI（0.548，5.852），P=0.043]，在舒张压的降压效果上，两者的效果相似[MD=0.1 mmHg，95%CI（-1.847，2.047），P=0.919]。两者的血压达标率及不良反应发生率相当。结论 奥美沙坦/氨氯地平复方制剂在收缩压的降压效果上优于缬沙坦/氨氯地平复方制剂，在舒张压的降压效果上，两者的效果相似。

Abstract:

OBJECTIVE To analyze and evaluate of the effect of olmesartan/amlodipine and valsartan/amlodipine fixed-dose combination in the treatment of essential hypertension patients by network meta-analysis. METHODS PubMed, Wanfang, CNKI were searched to retrieve results from reported randomized controlled trials in literature. Upon assessing the quality of publications in accordance to the Cochrane Handbook, conducted the network meta-analysis and indirect treatment comparison using the R3.4.3 and ITC software. RESULTS The final meta-analysis included a total of 9 studies and 3 137 patients. The olmesartan/amlodipine fixed-dose combination was statistically superior to valsartan/amlodipine fixed-dose combination in reducing systolic blood pressure[MD=3.2 mmHg, 95%CI(0.548, 5.852), P=0.043]. There was no difference for lowering diastolic blood pressure between the two treatments[MD=0.1 mmHg, 95%CI(-1.847, 2.047), P=0.919]. There was no difference for blood pressure control rate and adverse effects rate between the two treatments. CONCLUSION Olmesartan/amlodipine fixed-dose combination has superior systolic blood pressure lowering effect compared with valsartan/amlodipine fixed-dose combination but the two treatments are comparable for lowering diastolic blood pressure.