Bevacizumab and ranibizumab for neovascular age-related macular degeneration: an updated meta-analysis of randomised clinical trialsReport as inadecuate




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Graefe-s Archive for Clinical and Experimental Ophthalmology

, Volume 252, Issue 10, pp 1529–1537

First Online: 22 August 2014Received: 18 April 2014Revised: 18 July 2014Accepted: 30 July 2014

Abstract

PurposeNeovascular age-related macular degeneration AMD is the main cause of central vision loss among individuals aged 50 years or older in developed countries. The aim of this study was to review systematically the effect of bevacizumab compared to ranibizumab in patients with AMD at 1 year.

MethodsA systematic review was performed on Medline, Embase, and the Cochrane Library and Trial registers to October 2013. Eligibility criteria for selecting studies were randomised controlled trials RCT comparing bevacizumab with ranibizumab in patients with neovascular AMD. Odds ratio OR and mean difference MD estimates were synthesized under fixed- and random-effects models. Heterogeneity was assessed using the Q statistic and I.

ResultsFive RCTs were included, representing 2,686 randomised patients. The meta-analysis confirmed the non-inferiority of bevacizumab compared to ranibizumab for change in visual acuity at 1 year MD 0.57 letters, −1.80 to 0.66, p = 0.37, I = 0 %. Better anatomical results were found for ranibizumab. Bevacizumab was associated with a 34 % increase in the number of patients with at least one serious systemic adverse event OR 1.34, 1.08 to 1.66, p = 0.01, I = 0 %.

ConclusionsThe pooled evidence confirmed that, compared with ranibizumab, bevacizumab was associated with equivalent effects on visual acuity at 1 year and with a higher risk of systemic serious adverse events. The current available data do not show which types of adverse events occur more frequently. In practice, bevacizumab should be used under a risk-management plan until further studies have been carried out to assess accurately the increased risk of systemic adverse events.

KeywordsBevacizumab Ranibizumab Neovascular age-related macular degeneration Meta-analysis  Download fulltext PDF



Author: Laurent Kodjikian - Evelyne Decullier - Eric H. Souied - Jean-François Girmens - Emilie E. Durand - François R. Chapuis

Source: https://link.springer.com/







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