Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis

Virgili, Gianni; Parravano, Mariacristina; Evans, Jennifer R; Gordon, Iris; Lucenteforte, Ersilia

doi:10.1002/14651858.cd007419.pub5

Cited by 150 publications

(112 citation statements)

References 103 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, ranibizumab and bevacizumab did not show significant differences [ 28 , 33 ]. A previous meta-analysis study also confirmed that bevacizumab and ranibizumab did not differ in terms of BCVA, but ranibizumab was more effective in terms of CST reduction with a low-certainty of evidence [ 43 ]. To reinforce the validity of our meta-analysis, clinical trials comparing the 3 anti-VEGF agents with the DEX implant as well as extended follow-up trials should be conducted in the future.…”

Section: Discussionmentioning

confidence: 79%

A meta-analysis of the effect of a dexamethasone intravitreal implant versus intravitreal anti-vascular endothelial growth factor treatment for diabetic macular edema

Ren

et al. 2018

BMC Ophthalmol

100

View full text Add to dashboard Cite

BackgroundThis meta-analysis evaluated the effectiveness and safety of dexamethasone (DEX) implant and intravitreal anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular edema (DME).MethodsThe PubMed, Embase, clinicaltrials.gov website and Cochrane Library databases were comprehensively searched for studies comparing DEX implant with anti-VEGF in patients with DME. Best-corrected visual acuity (BCVA), central subfield thickness (CST) and adverse events were extracted from the final eligible studies. Review Manager (RevMan) 5.3 for Mac was used to analyze the data and GRADE profiler were used to access the quality of outcomes.ResultsBased on four randomized clinical trials assessing a total of 521 eyes, the DEX implant can achieve visual acuity improvement for DME at rates similar to those achieved via anti-VEGF treatment (mean difference [MD] = − 0.43, P = 0.35), with superior anatomic outcomes at 6 months (MD = − 86.71 μm, P = 0.02), while requiring fewer injections, in comparison to anti-VEGF treatment. Although the mean reduction in CST did not showed significant difference at 12 months (MD = − 33.77 μm, P = 0.21), the significant in BCVA from baseline to 12 months supported the anti-VEGF treatment (MD = − 3.26, P < 0.00001). No statistically significant differences in terms of the serious adverse events. However, use of the DEX implant has higher risk of intraocular pressure elevation and cataract than anti-VEGF treatment.ConclusionsCompared with anti-VEGF, DEX implant improved anatomical outcomes significantly. However, this did not translate to improved visual acuity, which may be due to the progression of cataract. Therefore, the DEX implant may be recommended as a first chioce for select cases, such as for pseudophakic eyes, anti-VEGF-resistant eyes, or patients reluctant to receive intravitreal injections frequently.Electronic supplementary materialThe online version of this article (10.1186/s12886-018-0779-1) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 79%

A meta-analysis of the effect of a dexamethasone intravitreal implant versus intravitreal anti-vascular endothelial growth factor treatment for diabetic macular edema

Ren

et al. 2018

BMC Ophthalmol

100

View full text Add to dashboard Cite

show abstract

“…This might be a reflection of under treatment and reduced follow-up, specifically in treatment-naïve patients, which is reflective of any real-world evidence study. However, this gap appeared to be less in mCNV than in nAMD and DME studies [31,32]. This could also be due to the possibility that patients with mCNV are comparatively younger than patients with nAMD and DME and are more likely to notice any changes in their VA or distortion.…”

Section: Discussionmentioning

confidence: 90%

Real-world effectiveness and safety of ranibizumab for the treatment of myopic choroidal neovascularization: Results from the LUMINOUS study

Hamilton

Clemens

Minnella³

et al. 2020

PLoS ONE

View full text Add to dashboard Cite

To assess the 1-year effectiveness, safety, and treatment patterns of ranibizumab in patients with myopic choroidal neovascularization (mCNV) enrolled in the LUMINOUS study. Methods This 5-year, prospective, multicenter, observational, study enrolled 30,138 patients across all approved ranibizumab indications from outpatient ophthalmology clinics. 297 consenting patients (�18 years) with mCNV who were treatment-naïve or prior-treated with ranibizumab or other ocular treatments were enrolled, and treated with ranibizumab according to the local product label. The main outcomes are visual acuity (VA; Early Treatment Diabetic Retinopathy Study letters or equivalent), adverse events during the study, and treatment exposure over 1 year. Results are presented by prior treatment status of the study eye and injection frequency. Results Of the 297 mCNV patients recruited in the study, 108 were treatment-naïve and 175 were prior ranibizumab-treated. At baseline, the mean age of patients was 57.6 years, and 59.0

show abstract

“…No differences in overall safety between the three antiangiogenic drugs that are currently available but results are imprecise for cardiovascular events and death [ 38 ]. Therefore, storage of antiangiogenics within cells of intraocular tissues as observed in vivo after intravitreal injection into monkey eyes, may result in unknown side effects during long-term treatment of patients.…”

Section: Discussionmentioning

confidence: 99%

Effects of ranibizumab (Lucentis®) and bevacizumab (Avastin®) on human corneal endothelial cells

et al. 2018

View full text Add to dashboard Cite

BackgroundIngrowth of newly formed blood and lymph vessels (angiogenesis) from the limbus region into the cornea can be treated successfully by subconjunctival application of antiangiogenic agents. Currently, there are several angiogenesis inhibitors from various manufacturers available, such as vascular endothelial growth factor (VEGF) antibodies. The aim of the study was to investigate potential cytotoxic effects of two anti-VEGF agents, ranibizumab (Lucentis®) and bevacizumab (Avastin®) on the human corneal endothelium.MethodsHuman donor corneas, not suitable for corneal transplantation, were organ-cultured in the presence of either ranibizumab (Lucentis®) or bevacizumab (Avastin®) at different concentrations (group 1: 250 μg / ml, group 2: 25 μg / ml, group 3: 2.5 μg / ml) for a period of up to 4 weeks. Microscopic imaging for endothelial cell counting, detection of morphologic alterations of the endothelium, and molecular biology testing (Enzyme-linked Immunosorbent Assay [ELISA]) for metabolic changes was performed.ResultsBackground-corrected results showed neither a significant lactate dehydrogenase (LDH) change with increasing culturing time nor a significant difference between ranibizumab (Lucentis®) and bevacizumab (Avastin®) treatment. The endothelial cell density revealed also no statistically significant difference between the two treatment groups with ranibizumab (Lucentis®) and bevacizumab (Avastin®) at all concentrations tested in this study.ConclusionsIn this study, the anti-angiogenic agents ranibizumab (Lucentis®) and bevacizumab (Avastin®) demonstrated no cytotoxic effects on the corneal endothelium of human organ-cultured donor corneas over the limited study time period of 4 weeks. However, based on the study design (in-vitro) and the limited follow-up period, no conclusions on potential long-term effects can be drawn.

show abstract

Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis

Cited by 150 publications

References 103 publications

A meta-analysis of the effect of a dexamethasone intravitreal implant versus intravitreal anti-vascular endothelial growth factor treatment for diabetic macular edema

A meta-analysis of the effect of a dexamethasone intravitreal implant versus intravitreal anti-vascular endothelial growth factor treatment for diabetic macular edema

Real-world effectiveness and safety of ranibizumab for the treatment of myopic choroidal neovascularization: Results from the LUMINOUS study

Effects of ranibizumab (Lucentis®) and bevacizumab (Avastin®) on human corneal endothelial cells

Contact Info

Product

Resources

About