Comparative Efficacy and Safety of Advanced Intravitreal Therapeutic Agents for Noninfectious Uveitis: A Systematic Review and Network Meta-Analysis

作者全名："Liao, Weiting; Zhong, Zhenyu; Su, Guannan; Feng, Xiaojie; Yang, Peizeng"

作者地址："[Liao, Weiting; Zhong, Zhenyu; Su, Guannan; Feng, Xiaojie; Yang, Peizeng] Chongqing Med Univ, Affiliated Hosp 1, Chongqing Key Lab Ophthalmol,Natl Clin Res Ctr Oc, Chongqing Eye Inst,Chongqing Branch, Chongqing, Peoples R China"

通信作者："Yang, PZ (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Chongqing Key Lab Ophthalmol,Natl Clin Res Ctr Oc, Chongqing Eye Inst,Chongqing Branch, Chongqing, Peoples R China."

来源：FRONTIERS IN PHARMACOLOGY

ESI学科分类：PHARMACOLOGY & TOXICOLOGY

WOS号：WOS:000810769700001

JCR分区：Q1

影响因子：5.6

年份：2022

卷号：13

期号：　

开始页：　

结束页：　

文献类型：Review

关键词：drug implants; intravitreal agents; drug delivery system (DDS); steroid; anti-VEGF (vascular endothelial growth factor) agents

摘要："Background: To compare the efficacy and safety of advanced intravitreal therapeutic regimens, including a dexamethasone implant at 350 and 700 mu g; a fluocinolone acetonide (FA) implant, 0.2 mu g/day, 0.59 and 2.1 mg; intravitreal bevacizumab, 1.25 mg; intravitreal ranibizumab, 0.5 mg; intravitreal triamcinolone acetonide (IVTA), 2 and 4 mg; and standard of care (SOC, systemic therapy) for noninfectious uveitis. Methods: We searched the Cochrane Library database, EMBASE, Medline, clinicaltrials. gov until April 2021 with 13 RCTs (1806 participants) identified and conducted a pairwise and Bayesian network meta-analysis with random effects. Results: No specific regimen showed a statistically significant advantage or disadvantage to another treatment regimen with regard to efficacy. However, the FA implant, 0.59mg was associated with a higher risk of cataract (RR 4.41, 95% CI 1.51-13.13) and raise in intraocular pressure (IOP) (RR 2.53 95% CI 1.14-6.25) compared with SOC at 24 months. IVTA, 4mg at 6 months was associated with lower risk of IOP rising compared with FA implant, 0.2 mu g/day at 36 months (RR 3.43 95% CI 1.12-11.35). Conclusion: No intravitreal therapeutic regimens showed a significant advantage or disadvantage with regard to efficacy. However, SOC was associated with lower risk of side effects compared with FA implants. IVTA, 4 mg, might be the best choice with lowest risk of IOP rising."

基金机构：Natural Science Foundation Major International (Regional) Joint Research Project [81720108009]; National Natural Science Foundation Key Program [81930023]; Chongqing Chief Medical Scientist Project; Chongqing Outstanding Scientists Project; Chongqing Science and Technology Platform and Base Construction Program [cstc2014pt-sy10002]; Chongqing Key Laboratory of Ophthalmology (CSTC) [2008CA5003]

基金资助正文："The work was supported by Natural Science Foundation Major International (Regional) Joint Research Project (81720108009), National Natural Science Foundation Key Program (81930023), Chongqing Chief Medical Scientist Project (2018), Chongqing Outstanding Scientists Project (2019), Chongqing Science and Technology Platform and Base Construction Program (cstc2014pt-sy10002), Chongqing Key Laboratory of Ophthalmology (CSTC, 2008CA5003)."