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玻璃体内注射贝伐单抗和雷珠单抗治疗年龄相关性黄斑变性:一项多中心回顾性研究。

Intravitreal bevacizumab and ranibizumab for age-related macular degeneration a multicenter, retrospective study.

机构信息

Department of Ophthalmology, Southern California Permanente Medical Group, Baldwin Park, California, USA.

出版信息

Ophthalmology. 2010 Feb;117(2):298-302. doi: 10.1016/j.ophtha.2009.07.023. Epub 2009 Dec 6.

DOI:10.1016/j.ophtha.2009.07.023
PMID:19969368
Abstract

OBJECTIVE

To compare visual acuity (VA) outcomes after bevacizumab or ranibizumab treatment for AMD.

DESIGN

Comparative, retrospective case series.

PARTICIPANTS

We followed 452 patients in a retrospective study of exudative AMD treated with anti-vascular endothelial growth factor drugs; 324 patients were treated with bevacizumab and 128 patients with ranibizumab.

METHODS

All treatment-naïve patients who received either bevacizumab or ranibizumab were followed for 1 year. Baseline characteristics and VA were recorded using standard descriptive statistics.

MAIN OUTCOME MEASURES

Visual acuity.

RESULTS

At 12 months, the distribution of VA improved in both groups with 22.9% of bevacizumab and 25.0% of ranibizumab attaining >or=20/40. Improvement in vision was observed in 27.3% of the bevacizumab group and 20.2% of the ranibizumab group. The mean number of injections at 12 months was 4.4 for bevacizumab and 6.2 for ranibizumab. There were 8 (2%) deaths in the bevacizumab group and 4 (3%) in the ranibizumab group. Two patients developed endophthalmitis in the bevacizumab group and the ranibizumab group. The bevacizumab group had slightly worse acuity at baseline, but both groups showed improvement and stability of vision over time.

CONCLUSIONS

Both treatments seem to be effective in stabilizing VA loss. There was no difference in VA outcome between the 2 treatment groups. Because the study is a nonrandomized comparison, selection bias could mask a true treatment difference. Results from the Comparison of the Age-related Macular Degeneration Treatment Trials will provide more definitive information about the comparative effectiveness of these drugs.

摘要

目的

比较抗血管内皮生长因子药物治疗 AMD 后的视力(VA)结果。

设计

对比、回顾性病例系列。

参与者

我们对 452 例接受抗血管内皮生长因子药物治疗渗出性 AMD 的患者进行了回顾性研究;324 例患者接受贝伐单抗治疗,128 例患者接受雷珠单抗治疗。

方法

所有接受贝伐单抗或雷珠单抗治疗的初治患者均随访 1 年。采用标准描述性统计方法记录基线特征和 VA。

主要观察指标

视力。

结果

在 12 个月时,两组的 VA 分布均有所改善,贝伐单抗组有 22.9%、雷珠单抗组有 25.0%的患者达到>或=20/40。贝伐单抗组有 27.3%、雷珠单抗组有 20.2%的患者视力改善。贝伐单抗组在 12 个月时的平均注射次数为 4.4 次,雷珠单抗组为 6.2 次。贝伐单抗组有 8 例(2%)死亡,雷珠单抗组有 4 例(3%)。贝伐单抗组有 2 例发生眼内炎,雷珠单抗组有 1 例。贝伐单抗组基线时视力稍差,但两组随时间推移视力均有改善和稳定。

结论

两种治疗方法似乎都能有效稳定 VA 丧失。两组的 VA 结果无差异。由于该研究是一项非随机比较,选择偏倚可能掩盖了真实的治疗差异。年龄相关性黄斑变性治疗试验比较的结果将提供关于这些药物比较疗效的更明确信息。

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