Intravitreal Conbercept Injection with and without Grid Laser Photocoagulation in the Treatment of Diffuse Diabetic Macular Edema in Real-Life Clinical Practice

Xu, Yule; Rong, Ao; Yang, Bi; Xu, Wei

doi:10.1155/2016/2143082

Cited by 26 publications

(37 citation statements)

References 31 publications

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“…Even though the structural and functional merits of conbercept have been demonstrated in laboratories and it has been shown to be more cost-effective than ranibizumab in a small-sized clinical study,69 its therapeutic equivalency or superiority to VEGF mAbs has not been demonstrated in large-scale clinical trials. Furthermore, a small-sized clinical trial conducted in People’s Republic of China has compared the efficacy of the therapeutic modality combining laser with IVC with that of IVC alone 53. The results suggest that the combinatorial therapy may be a promising modality for DME due to its cost-effectiveness and reduced risk of adverse events, while maintaining equal efficacy.…”

Section: Discussionmentioning

confidence: 99%

“…However, a few clinical trials studying the therapeutic efficacy of combining conbercept with laser therapy have been reported. A retrospective study involving 51 patients was conducted in 2016 to compare the efficacy of IVC plus grid laser photocoagulation (GLP) with IVC alone in the treatment of diffuse DME 53. At 12 months after therapy, the mean BCVA improved 9.1±4.5 letter score in the IVC group and 7.5±4.2 letter score in the combination group.…”

Section: Clinical Trailsmentioning

confidence: 99%

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The efficacy and safety of aflibercept and conbercept in diabetic macular edema

Cai¹,

Yang²,

Li³

et al. 2018

DDDT

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Diabetic macular edema (DME) has shown an increasing prevalence during the past years and is the leading cause of diabetic retinopathy blindness. Traditional treatment modalities include laser and corticosteroid therapy, which, however, either act through unclear mechanisms or cause cataracts and elevated intraocular pressure. In recent years, as the pathogenic role of VEGF in DME has been well-recognized, the intravitreal injection of anti-VEGF drugs has become the first-line treatment of DME due to their great efficacy in improving visual acuity and mitigating macular edema. Advantages have been shown for aflibercept and conbercept, the two recombinant decoy receptors that can bind VEGF with high specificity and affinity, in DME treatment in clinical trials conducted both worldwide and in People’s Republic of China. This review introduces the structural characteristics and molecular mechanisms of action of these two anti-VEGF drugs, and summarizes the clinical trials evaluating their efficacy and safety, with the hope to provide clues for designing optimal and personalized therapeutic regimens for DME patients.

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Trailsmentioning

confidence: 99%

The efficacy and safety of aflibercept and conbercept in diabetic macular edema

Cai¹,

Yang²,

Li³

et al. 2018

DDDT

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“…271 Novel anti-VEGF therapies that may be more effective, durable and cheaper than current agents such as conbercept are currently in trial for DME. 272 Other agents involving combination therapy, such as Genentech's anti-VEGF/ANG-2 (RG7716), have yielded favorable efficacy and durability data in recent Phase II studies. 273 In addition, optimal strategies for combining anti-VEGF and corticosteroid treatment are still undergoing investigation despite the recent marginal results provided by protocol U of the DRCR network.…”

Section: Future Trends Diagnosticsmentioning

confidence: 99%

<p>The Evolving Treatment of Diabetic Retinopathy</p>

Mansour¹,

Browning²,

Wong³

et al. 2020

OPTH

165

119

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Purpose: To review the current therapeutic options for the management of diabetic retinopathy (DR) and diabetic macular edema (DME) and examine the evidence for integration of laser and pharmacotherapy. Methods: A review of the PubMed database was performed using the search terms diabetic retinopathy, diabetic macular edema, neovascularization, laser photocoagulation, intravitreal injection, vascular endothelial growth factor (VEGF), vitrectomy, pars plana vitreous surgery, antiangiogenic therapy. With additional cross-referencing, this yielded 835 publications of which 301 were selected based on content and relevance. Results: Many recent studies have evaluated the pharmacological, laser and surgical therapeutic strategies for the treatment and prevention of DR and DME. Several newer diagnostic systems such as optical coherence tomography (OCT), microperimetry, and multifocal electroretinography (mfERG) are also assisting in further refinements in the staging and classification of DR and DME. Pharmacological therapies for both DR and DME include both systemic and ocular agents. Systemic agents that promote intensive glycemic control, control of dyslipidemia and antagonists of the renin-angiotensin system demonstrate beneficial effects for both DR and DME. Ocular therapies include anti-VEGF agents, corticosteroids and nonsteroidal anti-inflammatory drugs. Laser therapy, both as panretinal and focal or grid applications continue to be employed in management of DR and DME. Refinements in laser devices have yielded more tissue-sparing (subthreshold) modes in which many of the benefits of conventional continuous wave (CW) lasers can be obtained without the adverse side effects. Recent attempts to lessen the burden of anti-VEGF injections by integrating laser therapy have met with mixed results. Increasingly, vitreoretinal surgical techniques are employed for less advanced stages of DR and DME. The development and use of smaller gauge instrumentation and advanced anesthesia agents have been associated with a trend toward earlier surgical intervention for diabetic retinopathy. Several novel drug delivery strategies are currently being examined with the goal of decreasing the therapeutic burden of monthly intravitreal injections. These fall into one of the five categories: non-biodegradable polymeric drug delivery systems, biodegradable polymeric drug delivery systems, nanoparticle-based drug delivery systems, ocular injection devices and with sustained release refillable devices. At present, there remains no one single strategy for the management of the particular stages of DR and DME as there are many options that have not been rigorously tested through large, randomized, controlled clinical trials. Conclusion: Pharmacotherapy, both ocular and systemic, will be the primary mode of intervention in the management of DR and DME in many cases when cost and treatment burden are less constrained. Conventional laser therapy has become a secondary intervention in these instances, but remains a first-line option when cost and ...

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“…us, therapeutic approach by inhibiting VEGF may be provided as an effective treatment of DME. Intravitreal anti-VEGF agents could significantly improve the vision and anatomic outcomes in DME patients, and their long-term efficacy and safety have been proven in numerous randomised trials [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Efficacy and Safety of Intravitreal Conbercept with Intravitreal Ranibizumab for Treatment of Diabetic Macular Edema: A Meta-Analysis

Sun

Zhang

Tian

et al. 2020

Journal of Ophthalmology

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Introduction. This meta-analysis aimed to compare the therapeutic effect and safety of intravitreal conbercept (IVC) versus intravitreal ranibizumab (IVR) in treatment of diabetic macular edema (DME). Methods. Relevant studies were identified through systemic searches of PubMed, Embase, Cochrane Library, Ovid, CNKI, and Wanfang database up to 28 February 2019. Changes in central retinal thickness (CRT) in μm and best-corrected visual acuity (BCVA) in logMAR equivalents at 1, 3, and 6 months after initial treatment were performed by pooled analysis. Adverse events (AEs) were evaluated. Results. Eight articles involving 588 patients with DME were identified for this meta-analysis. The results showed that IVC significantly improved BCVA compared with IVR at 6 mo (SMD = −0.74 95% CI: −1.28 to −0.2; p=0.029) in patients with DME. IVC was superior to IVR in reducing central retinal thickness (CRT at 1 mo (p<0.0001), 3 mo (p=0.025), and 6 mo (p=0.019)) from baseline with statistical significance. For AEs, the pooled results showed that no significant difference in the risk of intraocular pressure increased (OR = 1.71; 95% CI: 0.55 to 5.25; p=0.352) or conjunctival hemorrhage (OR = 0.89; 95% CI: 0.34 to 2.34; p=0.65) between two groups. Conclusions. This meta-analysis showed that IVC trended to be more effective than IVR in terms of functional and anatomic outcomes for treating DME.

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Intravitreal Conbercept Injection with and without Grid Laser Photocoagulation in the Treatment of Diffuse Diabetic Macular Edema in Real-Life Clinical Practice

Cited by 26 publications

References 31 publications

The efficacy and safety of aflibercept and conbercept in diabetic macular edema

The efficacy and safety of aflibercept and conbercept in diabetic macular edema

<p>The Evolving Treatment of Diabetic Retinopathy</p>

Comparison of the Efficacy and Safety of Intravitreal Conbercept with Intravitreal Ranibizumab for Treatment of Diabetic Macular Edema: A Meta-Analysis

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