Combination of bevacizumab and photodynamic therapy vs. bevacizumab monotherapy for the treatment of wet age-related macular degeneration: A meta-analysis of randomized controlled trials.

Exp Ther Med 2018 Aug 13;16(2):1187-1194. Epub 2018 Jun 13.

Department of Ophthalmology, Shanghai Tenth People's Hospital Affiliated with Tongji University, Shanghai 200072, P.R. China.

The purpose of this meta-analysis was to compare the efficacy and safety of the combination of bevacizumab and photodynamic therapy (PDT) with bevacizumab monotherapy for the treatment of age-related macular degeneration (AMD). Patients with active choroidal neovascularization (CNV) secondary to AMD were included in the present study. The treatment group included patients treated with a combination of bevacizumab and PDT and patients treated with bevacizumab monotherapy. Only randomized controlled trials (RCTs) were included in the analysis. The PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases were searched. Meta-analysis was performed using RevMan v.5.3 software, and best-corrected visual acuity (BCVA), central retinal thickness (CRT) and the average number of bevacizumab retreatments were assessed. A total of 5 RCTs were included in the analysis. There were no significant differences observed in the mean BCVA change between the combination treatment group and the bevacizumab monotherapy group [standard mean difference 0.20; 95% confidence interval (CI) -0.53, 0.93, P=0.59]. There were also no significant differences in the CRT increases between the two groups [weighted mean difference (WMD) -22.16, 95% CI -52.01 to 7.69, P=0.15]. No significant differences were observed in the proportions of patients gaining >15 letters between the two groups [risk ratio (RR) 0.86, 95% CI 0.64, 1.15, P=0.30]. However, the average number of the ranibizumab retreatments was significantly lower in the combination treatment group compared with the bevacizumab monotherapy group (WMD, -2.70, 95% CI -3.93 to -1.46; P<0.0001). Additionally, there were no significant differences in the rate of ocular adverse events (RR, 0.57; 95% CI, 0.27 to 1.22; P=0.15) and systemic adverse events (RR, 5.42; 95% CI, 0.29 to 101.77; P=0.26) between the two groups. In conclusion there were no significant differences in mean BCVA change, CRT increases, the proportions of patients gaining >15 letters, or the incidences of ocular adverse events and systemic adverse events. However, combination treatment may significantly reduce the average number of bevacizumab retreatments compared with monotherapy.

Download full-text PDF

Source
http://dx.doi.org/10.3892/etm.2018.6305DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6090202PMC
August 2018
28 Reads
0.941 Impact Factor

Publication Analysis

Top Keywords

bevacizumab monotherapy
20
controlled trials
12
combination treatment
12
treatment group
12
average number
12
combination bevacizumab
12
bevacizumab
9
adverse events
8
monotherapy group
8
rcts included
8
macular degeneration
8
patients treated
8
number bevacizumab
8
bevacizumab retreatments
8
age-related macular
8
differences observed
8
randomized controlled
8
bevacizumab photodynamic
8
photodynamic therapy
8
monotherapy treatment
8

Similar Publications