Key result
Roxithromycin slows abdominal aortic aneurysm growth compared to placebo in a network meta-analysis.
Why the study?
Abdominal aortic aneurysm progression lacks proven medications, prompting an indirect comparison of common drugs' effects on growth rate.
Do pharmacological agents reduce abdominal aortic aneurysm growth rate in patients with AAA?
Systematic Review (n=2,135)
Do pharmacological agents reduce abdominal aortic aneurysm growth rate in patients with AAA?
Standardized Mean Difference: -0.39 (95% CI -0.69–-0.1)
Roxithromycin, statins, and metformin show promise for potentially limiting abdominal aortic aneurysm expansion, though high-quality RCTs are needed for validation.
Roxithromycin may slow AAA growth; extends RCT meta-analytic support and warrants outcome-focused trials.
Background: Abdominal aortic aneurysm (AAA) progression lacks proven medications. This study aimed to indirectly compare common drugs' effects on AAA growth rate using a network meta-analysis (NMA) of randomized controlled trials (RCTs) and cohort studies, assessing the reliability of evidence. Methods: We systematically searched the Cochrane Library, Embase, Web of Science, and PubMed until 5 June 2025. A Bayesian NMA synthesized direct and indirect evidence on drug effects on AAA growth rate, using standardized mean differences (SMD) with credible intervals (CrI). Cohort study results were analyzed separately. Results: After screening, 11 RCTs (2,135 subjects) and 13 cohort studies were included. Pooled RCT results showed roxithromycin significantly reduced AAA growth (SMD [95% CrI]: 0.39 [-0.69 to -0.10]). Roxithromycin also demonstrated advantages over amlodipine and doxycycline in indirect comparisons. Propranolol, perindopril, metformin, azithromycin, and ticagrelor showed no significant benefits. Cohort studies linked slower growth to statins and glucose-lowering drugs (insulin, metformin). Conclusion: Roxithromycin, statins, and metformin show promise for potentially limiting AAA expansion. However, findings are constrained by methodological limitations (study design, sample size), necessitating future validation via high-quality RCTs.
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Wen et al. (2026) conducted a systematic review in Abdominal aortic aneurysm (AAA) (n=2,135). Roxithromycin vs. Placebo was evaluated on Annual growth rate of AAA diameter (SMD -0.39, 95% CI -0.69 to -0.10). Roxithromycin significantly reduced abdominal aortic aneurysm growth rate compared to placebo (SMD -0.39) in a network meta-analysis of randomized controlled trials.
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