Comparative Effectiveness of Intravitreal Anti-Vascular Endothelial Growth Factor Therapies for Managing Neovascular Age-Related Macular Degeneration: A Meta-Analysis.
| Title: | Comparative Effectiveness of Intravitreal Anti-Vascular Endothelial Growth Factor Therapies for Managing Neovascular Age-Related Macular Degeneration: A Meta-Analysis. |
|---|---|
| Authors: | Matonti F; Centre Monticelli Paradis, 433 Bis Rue Paradis, 13008 Marseille, France.; National Center for Scientific Research (CNRS), Timone Neuroscience Institue (INT), Aix Marseille University, 13008 Marseille, France.; Groupe Almaviva Santé, Clinique Juge, 13008 Marseille, France.; Korobelnik JF; Department of Ophthalmology, Bordeaux University Hospital, 33000 Bordeaux, France.; INSERM, BPH, UMR1219, Bordeaux University, 33000 Bordeaux, France.; Dot C; Department of Ophthalmology, Desgenettes Military Hospital, 69003 Lyon, France.; Gualino V; Clinique Honoré Cave, Department of Ophthalmology, 82000 Montauban, France.; Unité de Rétine, Ophthalmology Department, Hôpital Pierre-Paul Riquet, Toulouse University Hospital, 31300 Toulouse, France.; Place Baylac, TSA 40031, CEDEX 9, 31059 Toulouse, France.; Ophthalmology Department, AP-HP, Hôpital Lariboisière, Université de Paris, 75014 Paris, France.; Soler V; Unité de Rétine, Ophthalmology Department, Hôpital Pierre-Paul Riquet, Toulouse University Hospital, 31300 Toulouse, France.; University Toulouse III, 31000 Toulouse, France.; CERCO UMR 5549, Centre National de la Recherche Scientifique, 31000 Toulouse, France.; Mrejen S; Centre d'Imagerie et de Laser, 75015 Paris, France.; Centre Hospitalier National Ophtalmologique des 1520, 75012 Paris, France.; Delyfer MN; Department of Ophthalmology, Bordeaux University Hospital, 33000 Bordeaux, France.; INSERM, BPH, UMR1219, Bordeaux University, 33000 Bordeaux, France.; Baillif S; Department of Ophthalmology, Pasteur 2 University Hospital, Côte d'Azur University, 06108 Nice, France.; Streho M; Explore Vision Centre, 75001 Paris, France.; Department of Ophthalmology, Lariboisière Hospital, 75010 Paris, France.; Gascon P; Centre Monticelli Paradis, 433 Bis Rue Paradis, 13008 Marseille, France.; Department of Ophthalmology, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, 13008 Marseille, France.; Creuzot-Garcher C; Department of Ophthalmology, University Hospital, CHU Dijon, 21000 Dijon, France.; Kodjikian L; Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, 69002 Lyon, France.; UMR-CNRS 5510 Matéis, University of Lyon, 69622 Villeurbanne, France. |
| Source: | Journal of clinical medicine [J Clin Med] 2022 Mar 25; Vol. 11 (7). Date of Electronic Publication: 2022 Mar 25. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101606588 Publication Model: Electronic Cited Medium: Print ISSN: 2077-0383 (Print) Linking ISSN: 20770383 NLM ISO Abbreviation: J Clin Med Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Basel, Switzerland : MDPI AG, [2012]- |
| Abstract: | Intravitreal injections (IVI) of anti-vascular endothelial growth factor (anti-VEGF) have become the standard of care for age-related macular degeneration (AMD). Although most pivotal trials have used monthly injections, alternative strategies that enable the injections to be administered on a more flexible schedule, including pro re nata (PRN) and treat-and-extend (T&E) regimens, are being applied more frequently. This review sought to provide further scientific evidence about the visual outcomes and treatment burden among the currently available anti-VEGF agents and regimens, including aflibercept, ranibizumab, abicipar and brolucizumab. To this end, a systematic review of published randomized studies was conducted from the MEDLINE and EMBASE databases and the Cochrane library, and a meta-analysis was applied to the obtained data using single-means modeling to compare the efficacy and maintenance among the different available treatments and regimens at Years 1 and 2. Quality analysis identified the best-informed data for modeling purposes. Overall, 47 relevant publications were retrieved for the analysis. Superior efficacy, meaning that there were observed improvements in visual acuity (VA) and central retinal thickness (CRT), occurred with monthly versus PRN regimens, yet a higher IVI number was also observed. Conversely, the T&E regimens displayed similar efficacy to the monthly regimens, but with a reduced IVI number. Aflibercept T&E exhibited similar efficacy to ranibizumab T&E, but with significantly lower IVI numbers at both Year 1 (p < 0.0001) and Year 2 (p = 0.0011). Though all of the regimens resulted in maintained efficacy between Years 1 and 2, the required IVI number varied. The retrieved data did not enable other regimens or newer anti-VEGF agents such as brolucizumab to be compared. In conclusion, the T&E regimens were shown to be the most efficient, optimizing durable effectiveness whilst minimizing the IVI number in newly diagnosed exudative AMD, with aflibercept requiring the lowest IVI number. |
| References: | Cochrane Database Syst Rev. 2014 Aug 29;(8):CD005139. (PMID: 25170575); Eye (Lond). 2010 Oct;24(10):1561-7. (PMID: 20577273); Ophthalmology. 2013 Nov;120(11):2300-9. (PMID: 23916488); Ophthalmology. 2015 Jun;122(6):1212-9. (PMID: 25846847); Graefes Arch Clin Exp Ophthalmol. 2020 Mar;258(3):503-511. (PMID: 31889214); Ophthalmology. 2012 May;119(5):992-1000. (PMID: 22424834); Wien Klin Wochenschr. 2016 Aug;128(15-16):560-5. (PMID: 25787216); Ophthalmology. 2021 Jul;128(7):1027-1038. (PMID: 33221326); Eye (Lond). 2016 Feb;30(2):270-86. (PMID: 26634711); Ophthalmology. 2012 May;119(5):1001-10. (PMID: 22444829); Drug Des Devel Ther. 2016 Jun 02;10:1857-67. (PMID: 27330279); Ophthalmology. 2020 Oct;127(10):1331-1344. (PMID: 32471729); Graefes Arch Clin Exp Ophthalmol. 2017 May;255(5):923-934. (PMID: 28102456); Ophthalmologica. 2017;238(1-2):17-22. (PMID: 28402983); Hippokratia. 2010 Dec;14(Suppl 1):29-37. (PMID: 21487488); Ophthalmology. 2000 Dec;107(12):2224-32. (PMID: 11097601); Cochrane Database Syst Rev. 2020 May 5;5:CD012208. (PMID: 32374423); Acta Ophthalmol. 2020 May;98(3):267-273. (PMID: 31421024); Br J Ophthalmol. 2018 Apr;102(4):460-464. (PMID: 28779006); Acta Ophthalmol. 2014 Dec;92(8):713-23. (PMID: 24925048); Acta Ophthalmol. 2015 Sep;93(6):e458-64. (PMID: 25160859); Adv Ther. 2020 Mar;37(3):1173-1187. (PMID: 32016788); Eye (Lond). 2013 Dec;27(12):1429-31. (PMID: 24158023); JAMA Ophthalmol. 2019 Apr 1;137(4):372-379. (PMID: 30676617); Ophthalmology. 2018 Jan;125(1):57-65. (PMID: 28893454); Ophthalmology. 2019 May;126(5):723-734. (PMID: 30502372); Ophthalmology. 2012 Dec;119(12):2537-48. (PMID: 23084240); Am J Ophthalmol. 2007 Apr;143(4):679-80. (PMID: 17386275); Retina. 2013 Sep;33(8):1600-4. (PMID: 23549100); Ophthalmology. 2005 Apr;112(4):533-9. (PMID: 15808240); Br J Ophthalmol. 2012 May;96(5):714-8. (PMID: 22241923); JAMA Ophthalmol. 2020 Mar 1;138(3):244-250. (PMID: 31917441); Clin Ophthalmol. 2012;6:1519-25. (PMID: 23055673); Syst Rev. 2015 Jan 01;4:1. (PMID: 25554246); N Engl J Med. 2006 Oct 5;355(14):1432-44. (PMID: 17021319); Ophthalmology. 2020 Jan;127(1):72-84. (PMID: 30986442); Br J Clin Pharmacol. 2019 May;85(5):908-913. (PMID: 30680768); Ophthalmology. 2015 Jan;122(1):146-52. (PMID: 25227499); Ophthalmology. 2011 Apr;118(4):663-71. (PMID: 21459217); Ophthalmology. 2020 Apr;127(4S):S135-S145. (PMID: 32200813); Br J Ophthalmol. 2021 Nov;105(11):1475-1479. (PMID: 33130553); Acta Ophthalmol. 2013 May;91(3):e178-83. (PMID: 23241227); Ophthalmology. 2011 May;118(5):831-9. (PMID: 21146229); Ophthalmology. 2017 Sep;124(9):1296-1304. (PMID: 28551167); Ophthalmology. 2013 Feb;120(2):317-27. (PMID: 23174399); Ophthalmology. 2014 Nov;121(11):2181-92. (PMID: 25015215); Sao Paulo Med J. 2019 Nov-Dec;137(6):530-542. (PMID: 32159640); Ophthalmology. 2016 Jan;123(1):51-9. (PMID: 26477842); N Engl J Med. 2011 May 19;364(20):1897-908. (PMID: 21526923); Clin Ophthalmol. 2017 Jan 24;11:223-231. (PMID: 28182161); Ophthalmology. 2015 Dec;122(12):2514-22. (PMID: 26391465); Cochrane Database Syst Rev. 2016 Feb 08;2:CD011346. (PMID: 26857947); Ophthalmic Res. 2019;62(4):190-195. (PMID: 31454808); Ophthalmology. 2019 Jun;126(6):841-848. (PMID: 30677465); Int J Mol Sci. 2020 Nov 03;21(21):. (PMID: 33153227); Arq Bras Oftalmol. 2019 May-Jun;82(3):225-232. (PMID: 30810619); N Engl J Med. 2008 Jun 12;358(24):2606-17. (PMID: 18550876); Retina. 2015 Aug;35(8):1547-54. (PMID: 25784358); Ophthalmology. 2011 Jun;118(6):1098-106. (PMID: 21640258); BMC Ophthalmol. 2020 Jan 9;20(1):18. (PMID: 31918685); Br J Ophthalmol. 2013 Mar;97(3):266-71. (PMID: 23292928); Clin Ophthalmol. 2018 Mar 27;12:587-591. (PMID: 29628756) |
| Contributed Indexing: | Keywords: aflibercept; age-related macular degeneration (AMD); comparative therapies; effectiveness; intravitreal anti-vascular endothelial growth factor; meta-analysis; pro re nata regimen; ranibizumab; treat-and-extend |
| Entry Date(s): | Date Created: 20220412 Latest Revision: 20240826 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC8999505 |
| DOI: | 10.3390/jcm11071834 |
| PMID: | 35407439 |
| Database: | MEDLINE |
Journal Article