Aflibercept for long-term treatment of diabetic macular edema and proliferative diabetic retinopathy: a meta-analysis
PurposeThis meta-analysis compared the long-term (12 months or 24 months) efficacy and safety of intravitreal aflibercept injection (IAI) for diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR).MethodsWe selected 16 randomized controlled trials (RCTs) performed after 2015 that...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1144422/full |
| _version_ | 1827946860406374400 |
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| author | Xiao Xie Xiao Xie Xiao Xie Chao Lian Chao Lian Zhiping Zhang Meng Feng Wenqi Wang Wenqi Wang Wenqi Wang Xiaomeng Yuan Xiaomeng Yuan Yanmei Shi Yanmei Shi Yanmei Shi Tingting Liu Tingting Liu |
| author_facet | Xiao Xie Xiao Xie Xiao Xie Chao Lian Chao Lian Zhiping Zhang Meng Feng Wenqi Wang Wenqi Wang Wenqi Wang Xiaomeng Yuan Xiaomeng Yuan Yanmei Shi Yanmei Shi Yanmei Shi Tingting Liu Tingting Liu |
| author_sort | Xiao Xie |
| collection | DOAJ |
| description | PurposeThis meta-analysis compared the long-term (12 months or 24 months) efficacy and safety of intravitreal aflibercept injection (IAI) for diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR).MethodsWe selected 16 randomized controlled trials (RCTs) performed after 2015 that had a minimum of 12 months and up to 24 months of treatment and conducted a meta-analysis with Review Manager version 5.3. Visual acuity (VA), central subfield thickness (CST) and adverse events were the outcomes selected for evaluation from the eligible studies.ResultsBased on 16 RCTs, we evaluated a total of 7125 patients. For PDR and severe DME with poor baseline vision, after a minimum of 12 months and up to 24 months of treatment, the aflibercept treatment group obtained better VA improvement than the focal/grid laser photocoagulation treatment group (MD=13.30; 95%CI: 13.01~13.58; P<0.001) or other treatments (ranibizumab, focal/grid laser photocoagulation, PRP, et al.) group (MD=1.10; 95%CI: 1.05~1.16; P<0.001). In addition, the aflibercept treatment group got higher CST reduction than the focal/grid laser photocoagulation treatment (MD=-33.76; 95%CI: -45.53 ~ -21.99; P<0.001) or other treatments (ranibizumab, focal/grid laser photocoagulation, et al.) group (MD=-33.76; 95%CI: -45.53 ~ -21.99; P<0.001). There was no significant difference in the overall incidence of ocular and non-ocular adverse events in each treatment group.ConclusionsThis meta-analysis showed that the advantages of IAI are obvious in the management of DME and PDR with poor baseline vision for long-term observation (a minimum of 12 months and up to 24 months) with both VA improvement and CST reduction. Applied IAI separately trended to be more effective than panretinal photocoagulation separately in VA improvement for PDR. More parameters should be required to assess functional and anatomic outcomes. |
| first_indexed | 2024-03-13T11:06:58Z |
| format | Article |
| id | doaj.art-eabc7f1744494758a3a9116465012c9e |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-13T11:06:58Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-eabc7f1744494758a3a9116465012c9e2023-05-16T05:44:19ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-05-011410.3389/fendo.2023.11444221144422Aflibercept for long-term treatment of diabetic macular edema and proliferative diabetic retinopathy: a meta-analysisXiao Xie0Xiao Xie1Xiao Xie2Chao Lian3Chao Lian4Zhiping Zhang5Meng Feng6Wenqi Wang7Wenqi Wang8Wenqi Wang9Xiaomeng Yuan10Xiaomeng Yuan11Yanmei Shi12Yanmei Shi13Yanmei Shi14Tingting Liu15Tingting Liu16First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, ChinaEye Hospital of Shandong First Medical University, Shandong Eye Hospital, Jinan, ChinaState Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, ChinaEye Hospital of Shandong First Medical University, Shandong Eye Hospital, Jinan, ChinaState Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, ChinaChinese Medicine College, Shandong University of Traditional Chinese Medicine, Jinan, ChinaLaboratory Department, Affiliated Hospital of Shanxi University of Chinese Medicine, Xianyang, ChinaFirst Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, ChinaEye Hospital of Shandong First Medical University, Shandong Eye Hospital, Jinan, ChinaState Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, ChinaEye Hospital of Shandong First Medical University, Shandong Eye Hospital, Jinan, ChinaState Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, ChinaFirst Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, ChinaEye Hospital of Shandong First Medical University, Shandong Eye Hospital, Jinan, ChinaState Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, ChinaEye Hospital of Shandong First Medical University, Shandong Eye Hospital, Jinan, ChinaState Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, ChinaPurposeThis meta-analysis compared the long-term (12 months or 24 months) efficacy and safety of intravitreal aflibercept injection (IAI) for diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR).MethodsWe selected 16 randomized controlled trials (RCTs) performed after 2015 that had a minimum of 12 months and up to 24 months of treatment and conducted a meta-analysis with Review Manager version 5.3. Visual acuity (VA), central subfield thickness (CST) and adverse events were the outcomes selected for evaluation from the eligible studies.ResultsBased on 16 RCTs, we evaluated a total of 7125 patients. For PDR and severe DME with poor baseline vision, after a minimum of 12 months and up to 24 months of treatment, the aflibercept treatment group obtained better VA improvement than the focal/grid laser photocoagulation treatment group (MD=13.30; 95%CI: 13.01~13.58; P<0.001) or other treatments (ranibizumab, focal/grid laser photocoagulation, PRP, et al.) group (MD=1.10; 95%CI: 1.05~1.16; P<0.001). In addition, the aflibercept treatment group got higher CST reduction than the focal/grid laser photocoagulation treatment (MD=-33.76; 95%CI: -45.53 ~ -21.99; P<0.001) or other treatments (ranibizumab, focal/grid laser photocoagulation, et al.) group (MD=-33.76; 95%CI: -45.53 ~ -21.99; P<0.001). There was no significant difference in the overall incidence of ocular and non-ocular adverse events in each treatment group.ConclusionsThis meta-analysis showed that the advantages of IAI are obvious in the management of DME and PDR with poor baseline vision for long-term observation (a minimum of 12 months and up to 24 months) with both VA improvement and CST reduction. Applied IAI separately trended to be more effective than panretinal photocoagulation separately in VA improvement for PDR. More parameters should be required to assess functional and anatomic outcomes.https://www.frontiersin.org/articles/10.3389/fendo.2023.1144422/fulldiabetic macular edemaproliferative diabetic retinopathyafliberceptmeta-analysisanti-vascular endothelial growth factorfocal/grid laser photocoagulation |
| spellingShingle | Xiao Xie Xiao Xie Xiao Xie Chao Lian Chao Lian Zhiping Zhang Meng Feng Wenqi Wang Wenqi Wang Wenqi Wang Xiaomeng Yuan Xiaomeng Yuan Yanmei Shi Yanmei Shi Yanmei Shi Tingting Liu Tingting Liu Aflibercept for long-term treatment of diabetic macular edema and proliferative diabetic retinopathy: a meta-analysis Frontiers in Endocrinology diabetic macular edema proliferative diabetic retinopathy aflibercept meta-analysis anti-vascular endothelial growth factor focal/grid laser photocoagulation |
| title | Aflibercept for long-term treatment of diabetic macular edema and proliferative diabetic retinopathy: a meta-analysis |
| title_full | Aflibercept for long-term treatment of diabetic macular edema and proliferative diabetic retinopathy: a meta-analysis |
| title_fullStr | Aflibercept for long-term treatment of diabetic macular edema and proliferative diabetic retinopathy: a meta-analysis |
| title_full_unstemmed | Aflibercept for long-term treatment of diabetic macular edema and proliferative diabetic retinopathy: a meta-analysis |
| title_short | Aflibercept for long-term treatment of diabetic macular edema and proliferative diabetic retinopathy: a meta-analysis |
| title_sort | aflibercept for long term treatment of diabetic macular edema and proliferative diabetic retinopathy a meta analysis |
| topic | diabetic macular edema proliferative diabetic retinopathy aflibercept meta-analysis anti-vascular endothelial growth factor focal/grid laser photocoagulation |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1144422/full |
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