An updated review of long-term outcomes from randomized controlled trials in approved pharmaceuticals for diabetic macular edema

2016 ◽  
Vol 1 ◽  
pp. 12-12 ◽  
Author(s):  
Jia-Kang Wang ◽  
Tzu-Lun Huang ◽  
Pei-Yuan Su ◽  
Pei-Yao Chang
Keyword(s):  
Randomized Controlled Trials ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Controlled Trials ◽  
Long Term Outcomes ◽  
Randomized Controlled

scholarly journals Intravitreal corticosteroids for diabetic macular edema: a network meta-analysis of randomized controlled trials

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Lu Gao ◽  
Xu Zhao ◽  
Lei Jiao ◽  
Luosheng Tang
Keyword(s):  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Short Term ◽  
Randomized Controlled

Abstract Background To evaluate the efficacy and safety of different intravitreal corticosteroids for treating diabetic macular edema (DME). Methods Four databases were systematically searched for randomized controlled trials comparing different intravitreal corticosteroids for treating DME. The primary outcome was the change in best-corrected visual acuity (BCVA) within 6 months after the first injection (short-term BCVA). Secondary outcomes were the change in BCVA over 1 year (long-term BCVA) and changes in central macular thickness (CMT) and intraocular pressure (IOP) within 6 months after the first injection. Network meta-analysis was performed to aggregate the results from the individual studies. Results Nineteen trials involving 2839 eyes were included. Intravitreal triamcinolone acetonide (TA) injections (≥ 8 mg and 4–8 mg), fluocinolone acetonide (FA) implants (0.5 µg/day) and dexamethasone (DEX) implants (700 µg) improved short-term BCVA (mean changes in logMAR [95% confidence interval] − 0.27 [− 0.40, − 0.15]; − 0.12 [− 0.18, − 0.06]; − 0.10 [− 0.21, − 0.01]; and − 0.06 [− 0.11, − 0.01]). Intravitreal TA injections (4 mg, multiple times), FA implants (0.5 µg/day and 0.2 µg/day), and DEX implants (350 µg) improved long-term BCVA (mean changes in logMAR [95% confidence interval] − 0.11 [− 0.21, − 0.02]; − 0.09 [− 0.15, − 0.03]; − 0.09 [− 0.14, − 0.02]; and − 0.04 [− 0.07, − 0.01]). All intravitreal corticosteroids reduced CMT, and different dosages of TA did not show significant differences in increasing IOP. Conclusions Intravitreal corticosteroids effectively improved BCVA in DME patients, with higher dosages showing greater efficacies. TA was not inferior to FA or DEX and may be considered a low-cost alternative choice for DME patients. The long-term efficacy and safety of different corticosteroids deserve further investigation. Trial registration Prospectively registered: PROSPERO, CRD42020219870

scholarly journals Long-term outcomes in the management of left main disease: An updated meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Dimitrios Terentes-Printzios ◽  
Rafail A. Kotronias ◽  
Giovanni Luigi De Maria ◽  
Roberto Scarsini ◽  
Adrian P. Banning
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Left Main ◽  
Long Term Outcomes ◽  
Left Main Disease ◽  
Randomized Controlled

scholarly journals Efficacy of Antiangiogenic Drugs in the Treatment of Diabetic Macular Edema: A Bayesian Network Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Xuexue Zhang ◽  
Yi Liu ◽  
Miaoran Wang ◽  
Qiuyan Li ◽  
Wantong Zhang ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Diabetic Macular Edema ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Antiangiogenic Drugs

Aims: To compare the efficacy of five kinds of antiangiogenic drugs in the treatment of diabetic macular edemaMethods: A comprehensive search of seven databases without language restrictions includes PubMed, EMBASE, Web of Science, CBM, the Cochrane Library, CNKI, and WanFang date. All literature used was published before October 2020. Eligible randomized trials were screened for inclusion in this study, and Bayesian framework was used to perform a network meta-analysis (NMA). Data on the mean change of best-corrected visual acuity (BCVA), central macular thickness (CMT) and intraocular pressure (IOP) at 6 months were extracted.Results: 25 randomized controlled trials (RCTs) that covered 2214 eyes, which received treatment of more than 3 months durations were included. In the pooled pair-wise meta-analysis, there was no statistically significant difference between all treatments. The same result was observed in the network meta-analysis with 0–37.82% Global I-squared. For BCVA at 6 months, conbercept and ranibizumab may be favorable than bevacizumab, aflibercept, triamcinolone acetonide and sham injections according to the ranking probabilities. As for CMT at 6 months, ranibizumab may be the most effective compared to bevacizumab, aflibercept and triamcinolone acetonide. In terms of IOP at 6 months, ranibizumab have better effect than bevacizumab, triamcinolone acetonide and sham injections. The results of sensitivity analysis also confirm it.Conclusion: The analysis confirms that ranibizumab may be the most favorable for BCVA improvement and have a stronger efficacy in decreasing CMT and IOP than other drugs when taking all the indicators into consideration. This conclusion may provide clinical evidence to guide treatment decisions. However, more high-quality randomized controlled trials will be necessary to further confirm this.

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