| Title: |
Anti-VEGF drugs compared with laser photocoagulation for the treatment of proliferative diabetic retinopathy: a systematic review and individual participant data meta-analysis |
| Authors: |
Simmonds, Mark; Llewellyn, Alexis; Walker, Ruth; Fulbright, Helen; Walton, Matthew; Hodgson, Rob; Bojke, Laura; Stewart, Lesley; Dias, Sofia; Rush, Thomas; Figueira, João Pereira; Sivaprasad, Sobha; Lawrenson, John G; Peto, Tunde; Steel, David |
| Source: |
Simmonds, M, Llewellyn, A, Walker, R, Fulbright, H, Walton, M, Hodgson, R, Bojke, L, Stewart, L, Dias, S, Rush, T, Figueira, J P, Sivaprasad, S, Lawrenson, J G, Peto, T & Steel, D 2025, 'Anti-VEGF drugs compared with laser photocoagulation for the treatment of proliferative diabetic retinopathy: a systematic review and individual participant data meta-analysis', Health Technology Assessment, vol. 29, no. 23, pp. 89-163. https://doi.org/10.3310/MJYP6578 |
| Publication Year: |
2025 |
| Collection: |
Queen's University Belfast: Research Portal |
| Subject Terms: |
anti-VEGF; laser photocoagulation; /dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being; name=SDG 3 - Good Health and Well-being |
| Description: |
Background Proliferative diabetic retinopathy is a major cause of sight loss in people with diabetes, with a high risk of vitreous haemorrhage, tractional retinal detachment and other complications. Panretinal photocoagulation is the primary established treatment for proliferative diabetic retinopathy. Anti-vascular endothelial growth factor drugs are used to treat various eye conditions and may be beneficial for people with proliferative diabetic retinopathy. Objective To investigate the efficacy and safety of anti-vascular endothelial growth factor therapy for the treatment of proliferative diabetic retinopathy when compared to panretinal photocoagulation. Methods A systematic review and network meta-analysis of randomised controlled trials comparing anti-vascular endothelial growth factor (alone or in combination) to panretinal photocoagulation in people with proliferative diabetic retinopathy. The database searches were updated in May 2023. Trials where the primary focus was treatment of macular oedema or vitreous haemorrhage were excluded. Key outcomes were best corrected visual acuity, diabetic macular oedema and vitreous haemorrhage. Individual participant data were obtained and analysed for three large, high-quality trials in combination with published data from other trials. Network meta-analyses of best corrected visual acuity and meta-analyses of other outcomes combined individual participant data with published data from other trials; regression analyses against patient covariates used just the individual participant data. Results Twelve trials were included: one of aflibercept, five of bevacizumab and six of ranibizumab. Individual participant data were available from 1 aflibercept and 2 ranibizumab trials, representing 624 patients (33% of the total). When considered together, anti-vascular endothelial growth factors produced a modest, but not clinically meaningful, benefit over panretinal photocoagulation in best corrected visual acuity, after 1 year of follow-up (mean difference in logarithm of ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| ISSN: |
1366-5278; 2046-4924 |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/40186529; info:eu-repo/semantics/altIdentifier/pissn/1366-5278; info:eu-repo/semantics/altIdentifier/eissn/2046-4924 |
| DOI: |
10.3310/MJYP6578 |
| Availability: |
https://pure.qub.ac.uk/en/publications/2819157e-e8d5-4354-9683-3147b6af347f; https://doi.org/10.3310/MJYP6578; https://pureadmin.qub.ac.uk/ws/files/664956752/anttttttttt.pdf |
| Rights: |
info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.A5F5B49F |
| Database: |
BASE |