Reddy U, Kryzstolik M
Brown Medical School, Box G-8064, 593 Eddy Street, Providence, Rhode Island 02903, USA.
Cochrane Database Syst Rev. 2006 Jan 25;2006(1):CD005138. doi: 10.1002/14651858.CD005138.pub2.
Antiangiogenic therapy is a new approach to the treatment of neovascular age-related macular degeneration. Interferon alfa is one antiangiogenic agent thought to function by inhibiting the migration and proliferation of vascular endothelial cells. It has been used in the treatment of hepatitis, solid tumors and hematologic malignancies.
The aim of this review was to investigate interferon alfa as a treatment modality for neovascular age-related macular degeneration.
We searched and identified trials from the Cochrane Central Register of Controlled Trials (CENTRAL), which contains the Cochrane Eyes and Vision Group Trials Register, in The Cochrane Library (Issue 2, 2005), MEDLINE (1966 to 2005/06 week 1), EMBASE (1980 to 2005/week 23), LILACS (Latin American and Caribbean Health Science Literature Database) (June 2005) and the reference lists of included studies.
This review included randomized controlled trials evaluating interferon alfa therapy in people with neovascular age-related macular degeneration who were followed for at least one year.
Both review authors independently extracted data and assessed trial quality. No data synthesis was conducted as only one trial met the inclusion criteria.
The one included trial enrolled and randomized 481 participants from 45 centers worldwide into four groups. The study allowed for analysis of the number of participants who had lost three or more lines of vision at 52 weeks in three interferon alfa-2a groups versus placebo. The results show an odds ratio of 1.60 (95% Confidence Interval 1.01 to 2.53) indicating that interferon is associated with a 60% increased odds of losing three or more lines at 52 weeks. This finding is marginally statistical with a P value of 0.04 and indicates that the treatment has the potential for harm rather than benefit.
AUTHORS' CONCLUSIONS: At present there is not enough evidence to recommend the use of interferon alfa-2a for the treatment of age-related macular degeneration.
抗血管生成疗法是治疗新生血管性年龄相关性黄斑变性的一种新方法。干扰素α是一种抗血管生成药物，被认为通过抑制血管内皮细胞的迁移和增殖发挥作用。它已被用于治疗肝炎、实体瘤和血液系统恶性肿瘤。
本综述的目的是研究干扰素α作为新生血管性年龄相关性黄斑变性的一种治疗方式。
我们在Cochrane图书馆（2005年第2期）的Cochrane对照试验中心注册库（CENTRAL，其中包含Cochrane眼科和视力组试验注册库）、MEDLINE（1966年至2005/06第1周）、EMBASE（1980年至2005/第23周）、LILACS（拉丁美洲和加勒比卫生科学文献数据库）（2005年6月）以及纳入研究的参考文献列表中进行检索并识别试验。
本综述纳入了评估干扰素α疗法用于新生血管性年龄相关性黄斑变性患者且随访至少一年的随机对照试验。
两位综述作者独立提取数据并评估试验质量。由于只有一项试验符合纳入标准，因此未进行数据综合分析。
纳入的一项试验从全球45个中心招募了481名参与者并将其随机分为四组。该研究允许分析三个干扰素α - 2a组与安慰剂组中在52周时视力下降三行或更多行的参与者数量。结果显示比值比为1.60（95%置信区间1.01至2.53），表明干扰素与52周时视力下降三行或更多行的几率增加60%相关。这一发现具有边缘统计学意义，P值为0.04，表明该治疗具有潜在危害而非益处。
目前没有足够的证据推荐使用干扰素α - 2a治疗年龄相关性黄斑变性。
