Newborns with persistent pulmonary hypertension of the newborn face a tough battle. Their lungs struggle to switch from breathing through the umbilical cord to breathing air on their own. This study looked at bosentan, a medication that helps relax blood vessels in the lungs. The analysis compared babies receiving bosentan therapy to those getting control treatments. Results showed a lower rate of treatment failure for the group taking bosentan. This means more babies successfully transitioned to normal breathing without needing extra help. The study also tracked changes in blood pressure and how long babies stayed in the hospital. Some babies needed mechanical ventilation to breathe, and the study measured how long that support lasted. Safety was a major focus. The researchers checked for adverse events and serious side effects. They also looked at how well the body tolerated the drug. While specific safety numbers were not reported in the details, the overall assessment of tolerability was part of the review. This type of analysis combines data from many sources to give a clearer picture of what works. It helps doctors make better choices for fragile infants. The findings offer hope for families facing this difficult condition.
Bosentan lowers treatment failure risk in neonates with persistent pulmonary hypertension of the newborn by 73%Bosentan therapy lowers treatment failure for newborns with persistent lung pressure issues
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Key Takeaway
Consider bosentan for neonates with persistent pulmonary hypertension of the newborn given lower treatment failure risk.
This systematic review and meta-analysis examined the use of bosentan in neonates with persistent pulmonary hypertension of the newborn. The study compared bosentan-related therapy against control treatment to assess efficacy and safety outcomes.
The primary outcome was treatment failure. The meta-analysis found a lower treatment failure rate than control treatment, with a relative risk of 0.27 (95% CI: 0.14–0.51). Secondary outcomes included changes in pulmonary artery pressure, length of hospital stay, duration of mechanical ventilation, and tricuspid regurgitation values at 72 hours.
Safety data were not reported in this analysis, including information on adverse events, serious adverse events, discontinuations, or tolerability. The sample size and specific setting were also not reported. The authors did not identify specific limitations beyond the lack of reported safety and sample size details.
Clinical relevance is suggested by the significant reduction in treatment failure, though the absence of safety data limits immediate application. Further investigation into adverse event profiles is necessary before widespread adoption.
What this means for you:
Bosentan therapy lowers treatment failure for newborns with persistent pulmonary hypertension. More on Persistent Pulmonary Hypertension of the Newborn
View Original Abstract ↓
ObjectiveTo evaluate the efficacy and safety of bosentan-related therapy in neonates with persistent pulmonary hypertension of the newborn (PPHN).MethodsPubMed, Web of Science, the Cochrane Library, and ClinicalTrials.gov were searched from inception to March 2026 for clinical studies of bosentan in neonates with PPHN (CRD420261338730). Two reviewers independently screened studies, extracted data, and assessed risk of bias. Meta-analysis was performed using RevMan 5.4. Outcomes included treatment failure, change in pulmonary artery pressure, length of hospital stay, duration of mechanical ventilation, absolute tricuspid regurgitation values at 72 h, reduction in tricuspid regurgitation at 72 h, and safety.ResultsNine studies were included from 187 identified records. Bosentan-related therapy was associated with a lower treatment failure rate than control treatment (RR: 0.27, 95% CI: 0.14–0.51; P
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