Efficacy of sildenafil combined with statins in treating pulmonary hypertension secondary to chronic obstructive pulmonary disease

Abstract

Aims

This study aims to comprehensively assess the effectiveness and safety of combining sildenafil with statins for managing pulmonary hypertension secondary to COPD. By conducting a comprehensive meta-analysis, we seek to provide robust evidence to inform and optimize clinical decision-making for this challenging condition.

Methods

A systematic search of the literature was performed across various databases, such as CNKI, VIP Data, Wanfang Data, PubMed, Web of Science, and the Cochrane Library, to identify RCTs that assess the effectiveness of sildenafil and statins in combination for treating PH secondary to COPD.The search included all records available from the establishment of each database until October 2024.Data extraction and meta-analysis were carried out with RevMan 5.3 software. The primary outcome measures comprised 6MWD and mPAP. The secondary outcome measures included FEV1/FVC, hs-CRP,and PaO2.

Results

Our study encompassed a total of 12 randomized controlled trials involving 937 patients who all come from China.Our research findings indicate that Sildenafil combined with statins could enhance 6MWD,lower mPAP,rise FEV1/FVC and PaO₂, reduce hs-CRP of COPD-PH,in contrast to the control group.Adverse reactions associated with the combination therapy were generally mild and tolerable.

Conclusion

This combination therapy not only improves patients' exercise capacity, as evidenced by increased 6MWD, but also alleviates PH and enhances overall quality of life. Importantly, the therapy does not raise significant safety concerns. These findings support the integration of sildenafil-statin combination therapy into the clinical management of COPD-PH, offering a promising approach to improving patient outcomes.