NiuHuangJiangYa capsule for hypertension:a Bayesian dose-response analysis of multiple N-of-1 trials

摘要

Background:There is the limited evidence available from randomized controlled trials on the dose-response relationship of NiuHuangJiangYa capsule for hypertension.The objective of this study is to investigate the dose-response relationship of NiuHuangJiangYa capsule for hypertension based on multiple N-of-1 trials.Methods:This study was a secondary analysis of the data from a series of N-of-1 trials examining the efficacy of high-dose versus low-dose NiuHuangJiangYa capsule for hypertension.Hierarchical Bayesian models were used to aggregate these N-of-1 trials for estimating the population and individual treatment effects synchronously.Results:It showed that overall population estimates of the posterior mean difference in Systolic Blood Pressure reduction,Diastolic Blood Pressure reduction,and traditional Chinese medicine symptom score reduction were 3.18 mmHg(95%CIs:-4.69 to 9.04,posterior probability(>0):83.33%),0.8636 mmHg(95%CIs:-5.19 to 6.79,posterior probability(>0):63.38%),and 0.8384(95%CIs:-2.21 to 3.84,posterior probability(>0):77.05%)respectively.Individual posterior mean difference ranged from 1.237 to 5.628 with posterior probability(>0)ranging from 63.63%to 92.95%in Systolic Blood Pressure reduction,-0.714 to 3.423 with posterior probability(>0)ranging from 43.03%to 84.04%in Diastolic Blood Pressure reduction,and-0.5179 to 2.733 with posterior probability(>0)ranging from 27.02%to 97.73%in traditional Chinese medicine symptom score reduction.Conclusion:The efficacy of high-dose versus low-dose NiuHuangJiangYa capsule for hypertension may be various across patients.Further studies are warranted to investigate these findings.Moreover,Bayesian N-of-1 trial may be helpful to explore the optimal and personalized dosage of anti-hypertensive drugs.