Journal article
Effects of Aflibercept for Neovascular Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis of Observational Comparative Studies
Investigative ophthalmology & visual science, Vol.58(13), pp.5616-5627
11/01/2017
DOI: 10.1167/iovs.17-22471
PMCID: PMC5667400
PMID: 29094167
Abstract
To compare the effects of aflibercept and other anti-vascular endothelial growth factor (anti-VEGF) medications on both functional and anatomical outcomes for treatment-naïve neovascular age-related macular degeneration (nAMD) in the real world. A systematic review and meta-analysis of observational comparative studies. A total of 18 studies remained after literature selection and quality assessment of 1697 studies. The most common aflibercept treatment regimen was three monthly injections followed by pro re nata (PRN). Aflibercept and ranibizumab had similar effects in 2-year treatment. At 3, 6, 12, and 24 months, the differences in the logarithm of minimum angle of resolution (logMAR) decrease in aflibercept and ranibizumab groups were 0.00 (95% confidence interval [CI]: -0.03 to 0.02); 0.01 (95% CI: -0.02 to 0.05); -0.03 (95% CI: -0.07 to 0.01); and -0.06 (95% CI: -0.30 to 0.17), respectively; the differences in decrease of central retinal thickness (CRT) were 3.25 μm (95% CI: -15.03 to 21.53); 7.89 μm (95% CI: -31.91 to 47.69); 2.89 μm (95% CI: -18.33 to 24.11); and -2.42 μm (95% CI: -77.87 to 73.03), respectively. However, aflibercept was significantly more effective in patients with initial reduced visual acuity (logMAR >0.6 or <55 letters; P = 0.001). In the first year, treatment frequency was not significantly different for aflibercept and ranibizumab, but aflibercept required fewer injections than ranibizumab with PRN regimen (mean -0.90; 95% CI: -1.80 to 0.00). Aflibercept has comparable effects with ranibizumab for treatment-naïve nAMD in the real world, and may be more effective for patients with initial lower visual acuity.
Details
- Title: Subtitle
- Effects of Aflibercept for Neovascular Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis of Observational Comparative Studies
- Creators
- Yan Zhang - Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, United StatesCatherine Chioreso - Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, United StatesMarin L Schweizer - Department of Internal Medicine, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, United StatesMichael D Abràmoff - VA Center for Diagnosis and Treatment of Visual Loss, Iowa City, Iowa, United States
- Resource Type
- Journal article
- Publication Details
- Investigative ophthalmology & visual science, Vol.58(13), pp.5616-5627
- Publisher
- United States
- DOI
- 10.1167/iovs.17-22471
- PMID
- 29094167
- PMCID
- PMC5667400
- ISSN
- 0146-0404
- eISSN
- 1552-5783
- Language
- English
- Date published
- 11/01/2017
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Electrical and Computer Engineering; Epidemiology; Internal Medicine; Ophthalmology and Visual Sciences
- Record Identifier
- 9983806374502771
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