Intravitreal Injection of Anti-vascular Endothelial Growth Factor in Age-related Macular Degeneration: a Systematic Review
10.3341/jkos.2019.60.8.748
- Author:
Min Joo KANG
1
;
Sang Jin SHIN
;
Jae Kyung SUH
;
Songhee CHO
;
Hajin TCHOE
;
Jangmi YANG
;
Donghyun JEE
Author Information
1. Office of Economic Evaluation Research, National Evidence Based Healthcare Collaborating Agency, Seoul, Korea.
- Publication Type:Meta-Analysis
- Keywords:
Age-related macular degeneration;
Intravitreal injection;
Meta-analysis;
Ranibizumab
- MeSH:
Bevacizumab;
Diabetic Retinopathy;
Endothelial Growth Factors;
Humans;
Intravitreal Injections;
Macular Degeneration;
Odds Ratio;
Outcome Assessment (Health Care);
Ranibizumab;
Visual Acuity
- From:Journal of the Korean Ophthalmological Society
2019;60(8):748-757
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To compare the efficacy and safety of intravitreal injections of bevacizumab, ranibizumab, and aflibercept for the treatment of new patients with age-related macular degeneration (AMD). METHODS: We conducted an update of the most recent and high quality systematic reviews (Canadian Agency for Drug Technology in Health [CADTH] 2016). Three randomized clinical trials were added to 13 trials identified from the CADTH report. The efficacy outcomes were 1) average improvement in visual acuity, 2) proportion of patients who experienced an improvement in vision (an increase in best-corrected visual acuity (BCVA) of ≥ 15 on Early Treatment Diabetic Retinopathy Study [ETDRS] letters), and 3) proportion of patients who experienced worsening of vision (decrease in BCVA of ≥ 15 ETDRS letters). In addition, safety outcomes included systemic adverse events and ocular-related adverse events. To analyze the outcomes of 16 randomized controlled trials, we conducted meta-analyses on the outcome measures. RESULTS: There was no significant difference in efficacy outcomes among anti-vascular endothelial growth factor (anti-VEGF) drugs. The mean difference in BCVA between ranibizumab and bevacizumab was 0.33 (95% confidence interval [CI]: −1.29, 1.95), and the odds ratio (OR) for a vision gain in the BCVA of ≥ 15 ETDRS letters for the ranibizumab versus aflibercept treatment was 1.02 (95% CI: 0.80, 1.30). There was also no significant difference in safety outcomes, except in terms of arterial thromboembolic events (ranibizumab vs. bevacizumab; OR: 2.15; 95% CI: 1.04, 4.41). CONCLUSIONS: The efficacy of anti-VEGF drugs for AMD patients was not significantly different. The safety of the drugs was also not significantly different, except in terms of arterial thromboembolic events.
