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Krysanov I.S.
Russian University of Medicine;
Medical Institute of Continuing Education of the Russian Biotechnological University
Krysanova V.S.
Medical Institute of Continuing Education of the Russian Biotechnological University
Ermakova V.Yu.
I.M. Sechenov First Moscow State Medical University (Sechenov University);
OOO Institut kliniko-ekonomicheskoi ekspertizy i farmakoekonomiki
Indirect comparison of anti-angiogenic agents in the treatment of diabetic macular edema
Journal: Russian Annals of Ophthalmology. 2024;140(6): 69‑79
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To cite this article:
Klabukova DL, Krysanov IS, Krysanova VS, Ermakova VYu. Indirect comparison of anti-angiogenic agents in the treatment of diabetic macular edema. Russian Annals of Ophthalmology.
2024;140(6):69‑79. (In Russ.)
https://doi.org/10.17116/oftalma202414006169
Diabetic macular edema (DME) is a leading cause of visual impairment and blindness among diabetic patients, its prevalence is continuing to increase worldwide. Faricimab, a bispecific antibody, represents a new generation of treatments for DME.
This study presents an indirect comparison of the effectiveness and safety of faricimab versus other treatment options for DME.
This systematic review of the effectiveness and safety of intravitreal injections (IVIs) of anti-angiogenic agents was conducted using the PRISMA methodology. Randomized clinical trials (RCTs) with outcomes at 12 months of DME treatment were included for network meta-analysis (NMA). Six endpoints were evaluated: the change in best-corrected visual acuity (BCVA), central retinal thickness (CRT); number of IVIs; proportion of patients with improved/deteriorated vision (per ETDRS); incidence of ophthalmic adverse events; and probability of treatment discontinuation. Evidence network diagrams and forest plots for faricimab 6.0 mg in a personalized treatment interval (PTI) regimen (up to one injection every 16 weeks) compared to aflibercept 2 mg and ranibizumab 0.5 mg were generated using RStudio.
Of 2845 initial publications, 38 studies were reviewed, and 20 RCTs were included in the base NMA. A random-effects model was applied for the NMA of injection frequency due to high heterogeneity, while fixed-effect models were used for other endpoints. Faricimab 6 mg in the PTI regimen demonstrated superior or comparable functional (BCVA improvement) and anatomical (CRT reduction) outcomes over 12 months with fewer injections than aflibercept 2 mg or ranibizumab 0.5 mg. Safety outcomes were similar across all anti-angiogenic agents.
The clinical efficacy and safety of faricimab, aflibercept and ranibizumab are comparable in adult patients with DME with a fewer number of faricimab IVIs vs comparators.
Keywords:
Authors:
Krysanov I.S.
Russian University of Medicine;
Medical Institute of Continuing Education of the Russian Biotechnological University
Krysanova V.S.
Medical Institute of Continuing Education of the Russian Biotechnological University
Ermakova V.Yu.
I.M. Sechenov First Moscow State Medical University (Sechenov University);
OOO Institut kliniko-ekonomicheskoi ekspertizy i farmakoekonomiki
Received:
15.10.2024
Accepted:
14.11.2024
List of references:
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