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 t hromboembolism (PTE) remains a controversial issue. The objective of this s tudy is to assess the efficacy and safety of thrombolytic therapy in the tr eatment of PTE by means of a meta-analysis of randomized controlled trials (RCT), METHODS: A bibliographic search of the main biomedical bibliographic databa ses was carried out and eight randomized controlled trials that fulfilled t he inclusion criteria were found. Two blinded and independent evaluators as sessed the quality of RCT according to Jadad scale, and selected the necess ary data to fulfill the objective of this study. RESULTS: The selected trials were heterogeneous regarding the type of throm bolytic 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 re lapse were found between the group of patients receiving thrombolytic agent s and the group not receiving them. Significant differences were found, how ever, between these two groups as regards the risk of bleeding events (OR = 2.62; CI 95%: 1.56-4.38). CONCLUSION: The results of these meta-analyses do not suggest the use of th rombolytic therapy in PTE in everyday clinical practice since measurable ri sks overcome potential benefits.