title: The efficacy of pharmacotherapy for decreasing the expansion rate of abdominal aortic aneurysms: a systematic review and meta-analysis.
abstract: BACKGROUND
  Pharmacotherapy may represent a potential means to limit the expansion rate of abdominal aortic aneurysms (AAAs). Studies evaluating the efficacy of different pharmacological agents to slow down human AAA-expansion rates have been performed, but they have never been systematically reviewed or summarized.
  
  
  RESULTS
  Two independent reviewers identified studies and selected randomized trials and prospective cohort studies comparing the growth rate of AAA in patients with pharmacotherapy vs. no pharmacotherapy. We extracted information on study interventions, baseline characteristics, methodological quality, and AAA growth rate differences (in mm/year). Fourteen prospective studies met eligibility criteria. Five cohort studies raised the possibility of benefit of beta-blockers [pooled growth rate difference: -0.62 mm/year, (95%CI, -1.00 to -0.24)], but this was not confirmed in three beta-blocker RCTs [pooled RCT growth rate difference: -0.05 mm/year (-0.16 to 0.05)]. Statins have been evaluated in two cohort studies that yield a pooled growth rate difference of -2.97 (-5.83 to -0.11). Doxycycline and roxithromycin have been evaluated in two RCTs that suggest possible benefit [pooled RCT growth rate difference: -1.32 mm/year (-2.89 to 0.25)]. Studies assessing NSAIDs, diuretics, calcium channel blockers and ACE inhibitors, meanwhile, did not find statistically significant differences.
  
  
  CONCLUSIONS
  Beta-blockers do not appear to significantly reduce the growth rate of AAAs. Statins and other anti-inflammatory agents appear to hold promise for decreasing the expansion rate of AAA, but need further evaluation before definitive recommendations can be made.
authors: Department of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland. idris.guessous@chuv.ch
authors: Idris
authors: I
authors: Guessous
authors: Daniel
authors: D
authors: Periard
authors: Diane
authors: D
authors: Lorenzetti
authors: Jacques
authors: J
authors: Cornuz
authors: William A
authors: WA
authors: Ghali
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000188:drug therapy* / Q000473:pathology; D015331:Cohort Studies; D004318:Doxycycline / Q000627:therapeutic use; D006801:Humans; D015575:Roxithromycin / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D015575:Roxithromycin; D004318:Doxycycline