Efficacy and Safety of Macitentan Across Pulmonary Hypertension Phenotypes: A Systematic Review and Meta-analysis

The study examined the efficacy and safety of macitentan, an endothelin receptor antagonist, in treating pulmonary hypertension. The analysis included 14 studies comparing macitentan with other treatments. Macitentan led to greater reduction in pulmonary vascular resistance (by 134.50 dyn.s.cm) and increased cardiac index (by 0.44 L/min/m²). No statistically significant difference was found in six-minute walk distance or mean pulmonary arterial pressure. Safety analysis showed lower mortality with macitentan use, but higher incidence of anemia, peripheral edema, and treatment discontinuation due to adverse events. The results suggest that macitentan has favorable effects on hemodynamic parameters, but without significant improvement in patients' functional capacity.