Comparative efficacy of anti-vascular endothelial growth factor on diabetic macular edema diagnosed with different patterns of optical coherence tomography: A network meta-analysis
Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections have emerged as the most common therapeutic approach for the management of diabetic macular edema (DME). Despite their proven superiority over other interventions, there is a paucity of data regarding the relative effectiven...
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| description | Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections have emerged as the most common therapeutic approach for the management of diabetic macular edema (DME). Despite their proven superiority over other interventions, there is a paucity of data regarding the relative effectiveness of anti-VEGF agents in treating DME diagnosed with different patterns of optical coherence tomography (OCT). In this regard, we conducted a systematic review and comparative analysis of the therapeutic efficacy of intravitreal bevacizumab, ranibizumab, aflibercept, and conbercept in the management of DME with diffuse retinal thickening (DRT), cystoid macular edema (CME), and serous retinal detachment (SRD) patterns identified using OCT. Our study encompassed a comprehensive search of PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Wan Fang Data from their inception until January 25, 2023. The network meta-analysis involved the inclusion of 1606 patients from 20 retrospective studies with a moderate risk of bias but no evidence of publication bias. The DRT group had the highest increase in best-corrected visual acuity (BCVA) with anti-VEGF, while the SRD group had the greatest reduction in Central Macular Thickness (CMT). Furthermore, conbercept, ranibizumab, and bevacizumab, respectively, showed the best treatment outcomes for patients with DRT, CME, and SRD in terms of improvement in BCVA. And, conbercept exhibited the highest reduction in CMT in the DRT, CME, and SRD groups. In conclusion, our study highlights the efficacy of anti-VEGF agents in the management of DME and provides valuable insights into the selection of anti-VEGF agents tailored to the individual needs of patients. |
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Despite their proven superiority over other interventions, there is a paucity of data regarding the relative effectiveness of anti-VEGF agents in treating DME diagnosed with different patterns of optical coherence tomography (OCT). In this regard, we conducted a systematic review and comparative analysis of the therapeutic efficacy of intravitreal bevacizumab, ranibizumab, aflibercept, and conbercept in the management of DME with diffuse retinal thickening (DRT), cystoid macular edema (CME), and serous retinal detachment (SRD) patterns identified using OCT. Our study encompassed a comprehensive search of PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Wan Fang Data from their inception until January 25, 2023. The network meta-analysis involved the inclusion of 1606 patients from 20 retrospective studies with a moderate risk of bias but no evidence of publication bias. The DRT group had the highest increase in best-corrected visual acuity (BCVA) with anti-VEGF, while the SRD group had the greatest reduction in Central Macular Thickness (CMT). Furthermore, conbercept, ranibizumab, and bevacizumab, respectively, showed the best treatment outcomes for patients with DRT, CME, and SRD in terms of improvement in BCVA. And, conbercept exhibited the highest reduction in CMT in the DRT, CME, and SRD groups. In conclusion, our study highlights the efficacy of anti-VEGF agents in the management of DME and provides valuable insights into the selection of anti-VEGF agents tailored to the individual needs of patients.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0304283</identifier><identifier>PMID: 38848379</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject><![CDATA[Acuity ; Angiogenesis Inhibitors - administration & dosage ; Angiogenesis Inhibitors - therapeutic use ; Bevacizumab ; Bevacizumab - administration & dosage ; Bevacizumab - therapeutic use ; Bias ; Biology and Life Sciences ; Clinical outcomes ; Comparative analysis ; Diabetes ; Diabetes mellitus ; Diabetic Retinopathy - diagnostic imaging ; Diabetic Retinopathy - drug therapy ; Dropsy ; Drug dosages ; Edema ; Effectiveness ; Growth factors ; Health aspects ; Humans ; Intervention ; Intravitreal Injections ; Macular Edema - diagnostic imaging ; Macular Edema - drug therapy ; Medical research ; Medicine and Health Sciences ; Medicine, Experimental ; Meta-analysis ; Network Meta-Analysis ; Optical Coherence Tomography ; Pathogenesis ; People and Places ; Physical Sciences ; Ranibizumab - administration & dosage ; Ranibizumab - therapeutic use ; Receptors, Vascular Endothelial Growth Factor - administration & dosage ; Receptors, Vascular Endothelial Growth Factor - therapeutic use ; Recombinant Fusion Proteins - administration & dosage ; Recombinant Fusion Proteins - therapeutic use ; Research and Analysis Methods ; Retina ; Retinal detachment ; Social Sciences ; Software ; Statistical analysis ; Systematic review ; Tomography ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular endothelial growth factor ; Vascular Endothelial Growth Factor A - antagonists & inhibitors ; Visual acuity ; Visual Acuity - drug effects]]></subject><ispartof>PloS one, 2024-06, Vol.19 (6), p.e0304283</ispartof><rights>Copyright: © 2024 Yao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Yao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Yao et al 2024 Yao et al</rights><rights>2024 Yao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c576t-774a0ccf4cdc872585ce757477c80655992b361f972aaf287a90a3f4c12bc6a03</cites><orcidid>0000-0002-9742-0540</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161126/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161126/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38848379$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yao, Jiajia</creatorcontrib><creatorcontrib>Huang, Wanli</creatorcontrib><creatorcontrib>Gao, Lixia</creatorcontrib><creatorcontrib>Liu, Yan</creatorcontrib><creatorcontrib>Zhang, Qi</creatorcontrib><creatorcontrib>He, Juncai</creatorcontrib><creatorcontrib>Zhang, Li</creatorcontrib><title>Comparative efficacy of anti-vascular endothelial growth factor on diabetic macular edema diagnosed with different patterns of optical coherence tomography: A network meta-analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections have emerged as the most common therapeutic approach for the management of diabetic macular edema (DME). Despite their proven superiority over other interventions, there is a paucity of data regarding the relative effectiveness of anti-VEGF agents in treating DME diagnosed with different patterns of optical coherence tomography (OCT). In this regard, we conducted a systematic review and comparative analysis of the therapeutic efficacy of intravitreal bevacizumab, ranibizumab, aflibercept, and conbercept in the management of DME with diffuse retinal thickening (DRT), cystoid macular edema (CME), and serous retinal detachment (SRD) patterns identified using OCT. Our study encompassed a comprehensive search of PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Wan Fang Data from their inception until January 25, 2023. The network meta-analysis involved the inclusion of 1606 patients from 20 retrospective studies with a moderate risk of bias but no evidence of publication bias. The DRT group had the highest increase in best-corrected visual acuity (BCVA) with anti-VEGF, while the SRD group had the greatest reduction in Central Macular Thickness (CMT). Furthermore, conbercept, ranibizumab, and bevacizumab, respectively, showed the best treatment outcomes for patients with DRT, CME, and SRD in terms of improvement in BCVA. And, conbercept exhibited the highest reduction in CMT in the DRT, CME, and SRD groups. 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yao, Jiajia</au><au>Huang, Wanli</au><au>Gao, Lixia</au><au>Liu, Yan</au><au>Zhang, Qi</au><au>He, Juncai</au><au>Zhang, Li</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparative efficacy of anti-vascular endothelial growth factor on diabetic macular edema diagnosed with different patterns of optical coherence tomography: A network meta-analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-06-07</date><risdate>2024</risdate><volume>19</volume><issue>6</issue><spage>e0304283</spage><pages>e0304283-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections have emerged as the most common therapeutic approach for the management of diabetic macular edema (DME). Despite their proven superiority over other interventions, there is a paucity of data regarding the relative effectiveness of anti-VEGF agents in treating DME diagnosed with different patterns of optical coherence tomography (OCT). In this regard, we conducted a systematic review and comparative analysis of the therapeutic efficacy of intravitreal bevacizumab, ranibizumab, aflibercept, and conbercept in the management of DME with diffuse retinal thickening (DRT), cystoid macular edema (CME), and serous retinal detachment (SRD) patterns identified using OCT. Our study encompassed a comprehensive search of PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Wan Fang Data from their inception until January 25, 2023. The network meta-analysis involved the inclusion of 1606 patients from 20 retrospective studies with a moderate risk of bias but no evidence of publication bias. The DRT group had the highest increase in best-corrected visual acuity (BCVA) with anti-VEGF, while the SRD group had the greatest reduction in Central Macular Thickness (CMT). Furthermore, conbercept, ranibizumab, and bevacizumab, respectively, showed the best treatment outcomes for patients with DRT, CME, and SRD in terms of improvement in BCVA. And, conbercept exhibited the highest reduction in CMT in the DRT, CME, and SRD groups. In conclusion, our study highlights the efficacy of anti-VEGF agents in the management of DME and provides valuable insights into the selection of anti-VEGF agents tailored to the individual needs of patients.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>38848379</pmid><doi>10.1371/journal.pone.0304283</doi><tpages>e0304283</tpages><orcidid>https://orcid.org/0000-0002-9742-0540</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_3069270617 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Acuity Angiogenesis Inhibitors - administration & dosage Angiogenesis Inhibitors - therapeutic use Bevacizumab Bevacizumab - administration & dosage Bevacizumab - therapeutic use Bias Biology and Life Sciences Clinical outcomes Comparative analysis Diabetes Diabetes mellitus Diabetic Retinopathy - diagnostic imaging Diabetic Retinopathy - drug therapy Dropsy Drug dosages Edema Effectiveness Growth factors Health aspects Humans Intervention Intravitreal Injections Macular Edema - diagnostic imaging Macular Edema - drug therapy Medical research Medicine and Health Sciences Medicine, Experimental Meta-analysis Network Meta-Analysis Optical Coherence Tomography Pathogenesis People and Places Physical Sciences Ranibizumab - administration & dosage Ranibizumab - therapeutic use Receptors, Vascular Endothelial Growth Factor - administration & dosage Receptors, Vascular Endothelial Growth Factor - therapeutic use Recombinant Fusion Proteins - administration & dosage Recombinant Fusion Proteins - therapeutic use Research and Analysis Methods Retina Retinal detachment Social Sciences Software Statistical analysis Systematic review Tomography Tomography, Optical Coherence Treatment Outcome Vascular endothelial growth factor Vascular Endothelial Growth Factor A - antagonists & inhibitors Visual acuity Visual Acuity - drug effects |
| title | Comparative efficacy of anti-vascular endothelial growth factor on diabetic macular edema diagnosed with different patterns of optical coherence tomography: A network meta-analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T10%3A40%3A17IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Comparative%20efficacy%20of%20anti-vascular%20endothelial%20growth%20factor%20on%20diabetic%20macular%20edema%20diagnosed%20with%20different%20patterns%20of%20optical%20coherence%20tomography:%20A%20network%20meta-analysis&rft.jtitle=PloS%20one&rft.au=Yao,%20Jiajia&rft.date=2024-06-07&rft.volume=19&rft.issue=6&rft.spage=e0304283&rft.pages=e0304283-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0304283&rft_dat=%3Cgale_plos_%3EA796927284%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3069270617&rft_id=info:pmid/38848379&rft_galeid=A796927284&rfr_iscdi=true |