Abstract
The aim of this network meta-analysis (NMA) was to compare the efficacy of various commonly used drugs in the treatment of patients with hypertrophic cardiomyopathy (HCM). Randomized controlled trials on drugs for HCM treatment were retrieved from PubMed, Embase, Cochrane Library, and Web of Science (search cutoff: January 10, 2024). Quality assessment was performed using the Risk of Bias tool, and data analysis utilized R software. 17 articles (1133 HCM patients) were included. NMA indicated that mavacamten and perhexiline improved peak oxygen consumption (pVO2) compared to placebo. Mavacamten reduced N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), left ventricular mass index (LVMI), left atrial volume index (LAVI), and septal E/e’ ratio. Losartan lowered systolic blood pressure, while candesartan, mavacamten, and valsartan reduced maximum wall thickness. Perhexiline had better efficacy in increasing pVO2, and candesartan in reducing maximum wall thickness. No drug significantly improved left ventricular ejection fraction (LVEF) compared to placebo. In conclusion, based on current studies, commonly used drugs may effectively improve some of the outcome measures in HCM patients, while the novel drug mavacamten showed significant therapeutic effects in most of the rest of the outcome measures except for LVEF.
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