康柏西普对比雷珠单抗治疗湿性年龄相关性黄斑变性疗效和安全性的Meta分析

目的:系统评价康柏西普对比雷珠单抗治疗湿性年龄相关性黄斑变性(wAMD)的疗效和安全性。方法:计算机检索PubMed、the Cochrance Library、Web of Science、Embase、Medline、CNKI、WanFang Data、VIP数据库,搜集有关康柏西普与雷珠单抗对比治疗wAMD的随机对照试验(RCT),检索时限均为建库至2019年7月23日。由两名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果:共纳入11个RCT,861只患眼。Meta分析结果显示:与雷珠单抗相比,康柏西普改善患者最佳矫正视力的效果更佳,差异有统计学意义[MD=-0.02,95%CI(-0.04,-0.00),P=0.04],而在黄斑中央厚度[MD=-2.20,95%CI(-7.21,2.82),P=0.39]、注射次数[MD=-0.48,95%CI(-1.26,0.30),P=0.23]和药品不良反应发生率[RR=1.10,95%CI(0.63,1.90),P=0.75]方面的差异均无统计学意义。结论:康柏西普治疗wAMD患者可改善患者最佳矫正视力,而黄斑中央厚度、注射次数和安全性方面康柏西普和雷珠单抗相当。受纳入研究数量和质量的限制,上述结论尚需更多高质量的研究进一步验证。

Efficacy and Safety of Conbercept Versus Ranibizumab in the Treatment of Wet Age-related Macular Degeneration:a Meta-analysis

Objective:To systematically review the efficacy and safety of conbercept versus ranibizumab in the treatment of wet age-related macular degeneration.Methods:PubMed,the Cochrane Library,Web of Science,Embase,Medline,CNKI,WanFang Data and VIP databases were electronically searched to collect randomized controlled trials(RCTs)on conbercept versus ranibizumab in the treatment of wet age-related macular degeneration from inception to July 23,2019.Two reviewers independently screened the literatures,extracted data and assessed the risk of bias of the included studies.Meta-analysis was performed by using RevMan 5.3 software.Results:Totally 11 RCTs involving 861 eyes were included.The results of Meta-analysis showed that,compared with ranibizumab group,the best corrected visual acuity(BCVA)in conbercept group was better(MD=-0.02,95%CI-0.04 to-0.00,P=0.04).There were no statistically significant differences of central macular thickness(MD=-2.20,95%CI-7.21 to 2.82,P=0.39),number of injections(MD=-0.48,95%CI-1.26 to 0.30,P=0.23),adverse drug reactions(RR=1.10,95%CI 0.63 to 1.90,P=0.75).Conclusion:Current evidence shows that conbercept was superior to ranibizumab in improving visual acuity in the treatment of wet age-related macular degeneration,while safety and other aspects are similar.Due to limited quality and quantity of the included studies,more high quality studies are needed to verify above conclusion further.