Nine cross-sectional studies (n=8,778) were included.
More than 90 days duration of treatment (8 studies).
The test for statistical heterogeneity was non significant after one atypical study was removed from the analysis. The prevalence of FDA criteria valvular regurgitation was 12.0% in the group who had taken fenfluramine-derivative diet pills, compared with 5.9% in the unexposed group (OR 2.2, 95% CI: 1.7, 2.7). The findings were not substantially altered when the excluded study was re-included in the analysis (data not provided).
There was no evidence of publication bias, either graphically or based on the formal tests.
Less than 90 days duration of treatment (2 studies).
There was no evidence of statistical heterogeneity. The prevalence of FDA criteria valvular regurgitation was 6.7% in the group who had taken fenfluramine-derivative diet pills, compared with 5.8% in the unexposed group (OR 1.4, 95% CI: 0.8, 2.4). Publication bias was not assessed due to the small sample size.
Sensitivity analyses did not have a substantial effect on the results. The authors also reported data from subgroup analyses based on drug type and mitral or aortic valve disease.