[Efficacy and safety of thrombolytic therapy in pulmonary embolism: meta-analysis of randomized controlled trials].
BACKGROUND
The role of thrombolytic agents in the treatment of pulmonary thromboembolism (PTE) remains a controversial issue. The objective of this study is to assess the efficacy and safety of thrombolytic therapy in the treatment of PTE by means of a meta-analysis of randomized controlled trials (RCT).


METHODS
A bibliographic search of the main biomedical bibliographic databases was carried out and eight randomized controlled trials that fulfilled the inclusion criteria were found. Two blinded and independent evaluators assessed the quality of RCT according to Jadad scale, and selected the necessary data to fulfill the objective of this study.


RESULTS
The selected trials were heterogeneous regarding the type of thrombolytic agent, the administration schedule, and the efficacy measures used. The methodological quality was 2 points in the Jadad scale as an average. No statistically significant differences in mortality nor in risk of PTE relapse were found between the group of patients receiving thrombolytic agents and the group not receiving them. Significant differences were found, however, between these two groups as regards the risk of bleeding events (OR = 2.62; CI 95%: 1.56-4.38).


CONCLUSIONS
The results of these meta-analyses do not suggest the use of thrombolytic therapy in PTE in everyday clinical practice since measurable risks overcome potential benefits.
Serra-Prat
M
M
Area de Recerca i Formació, Agència d'Avaluació de Tecnologia Mèdica, Barcelona. iguillam@olimpia.scs.es
Jovell
A J
AJ
Aymerich
M
M
D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D011655:Pulmonary Embolism / Q000188:drug therapy*; D012449:Safety; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D005343:Fibrinolytic Agents; D006493:Heparin; D014568:Urokinase-Type Plasminogen Activator
Eficacia y seguridad del tratamiento trombolítico en la tromboembolia pulmonar: metaanálisis de ensayos controlados y aleatorizados.