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眼压升高或青光眼患者使用拉坦前列素与其他前列腺素类似物相比的结膜充血情况:一项随机临床试验的荟萃分析

Conjunctival hyperaemia with the use of latanoprost versus other prostaglandin analogues in patients with ocular hypertension or glaucoma: a meta-analysis of randomised clinical trials.

作者信息

Honrubia F, García-Sánchez J, Polo V, de la Casa J M Martínez, Soto J

机构信息

Medical Unit, Pfizer Spain, Avda de Europa 20-B, Parque Empresarial de la Moraleja, 28108 Alcobendas, Madrid, Spain.

出版信息

Br J Ophthalmol. 2009 Mar;93(3):316-21. doi: 10.1136/bjo.2007.135111. Epub 2008 Nov 19.

Abstract

AIM

To conduct a meta-analysis of randomised clinical trials (RCTs) in order to evaluate the development of conjunctival hyperaemia after the use of latanoprost versus travoprost and bimatoprost, in patients with ocular hypertension or glaucoma.

METHODS

In order to identify the potentially relevant RCTs, a systematic literature retrieval was conducted in Medline, Embase and Cochrane Controlled Trials Register (1995-April 2007) databases The outcome measure was the appearance of conjunctival hyperaemia during the study. Statistical analyses included the calculation of odds ratio (OR) and its respective confidence interval, along with intertrial statistical heterogeneity. Publication bias was evaluated through a funnel plot, and a sensitivity analysis was also performed.

RESULTS

In total, 13 RCTs involving 2222 patients with ocular hypertension or glaucoma were included, five comparing latanoprost versus travoprost, seven comparing latanoprost versus bimatoprost and one comparing latanoprost versus travoprost and bimatoprost. The combined results showed that latanoprost produced lower occurrence of conjunctival hyperaemia than both travoprost (OR = 0.51; 95% CI 0.39 to 0.67, p<0.0001) and bimatoprost (OR = 0.32; 95% CI 0.24 to 0.42, p<0.0001). No significant heterogeneity was found between the included RCTs. There was no evidence of publication bias. In the sensitivity analysis performed, none of the clinical trials included in this meta-analysis has an important impact in the global estimation of OR.

CONCLUSIONS

According to available data, the use of latanoprost is associated with a lower incidence of conjunctival hyperaemia when compared with travoprost and bimatoprost in the treatment of patients with ocular hypertension or glaucoma.

摘要

目的

进行一项随机临床试验(RCT)的荟萃分析,以评估在高眼压症或青光眼患者中,使用拉坦前列素与曲伏前列素和比马前列素相比,结膜充血的发生情况。

方法

为了确定潜在相关的RCT,我们在Medline、Embase和Cochrane对照试验注册库(1995年 - 2007年4月)数据库中进行了系统的文献检索。研究的主要观察指标是研究期间结膜充血的出现情况。统计分析包括计算比值比(OR)及其相应的置信区间,以及试验间的统计异质性。通过漏斗图评估发表偏倚,并进行敏感性分析。

结果

总共纳入了13项涉及2222例高眼压症或青光眼患者的RCT,其中5项比较拉坦前列素与曲伏前列素,7项比较拉坦前列素与比马前列素,1项比较拉坦前列素与曲伏前列素和比马前列素。综合结果显示,与曲伏前列素(OR = 0.51;95% CI 0.39至0.67,p < 0.0001)和比马前列素(OR = 0.32;95% CI 0.24至0.42,p < 0.0001)相比,拉坦前列素引起结膜充血的发生率更低。纳入的RCT之间未发现显著异质性。没有发表偏倚的证据。在进行的敏感性分析中,本荟萃分析中纳入的任何一项临床试验对OR的总体估计均无重要影响。

结论

根据现有数据,在治疗高眼压症或青光眼患者时,与曲伏前列素和比马前列素相比,使用拉坦前列素与结膜充血发生率较低相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4744/2639645/c3d22b57f054/BJ1-93-03-0316-f01.jpg

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