拉坦前列素苯并噁唑治疗开角型青光眼和高眼压症的短期疗效：系统文献回顾和网络荟萃分析。
Short-term efficacy of latanoprostene bunod for the treatment of open-angle glaucoma and ocular hypertension: a systematic literature review and a network meta-analysis.
机构信息
Ophthalmology, University of Montreal, Montreal, Québec, Canada.
Pharmacoeconomics and Outcomes Research, PeriPharm Inc, Montreal, Québec, Canada.
出版信息
Br J Ophthalmol. 2022 May;106(5):640-647. doi: 10.1136/bjophthalmol-2020-317262. Epub 2021 Jan 4.
BACKGROUND/AIMS: To assess the comparative efficacy of latanoprostene bunod (LBN), a novel prostaglandin analogue (PGA), to other medications for open-angle glaucoma and ocular hypertension on lowering intraocular pressure (IOP).
METHODS
A systematic literature review adapted from the Li (Ophthalmology, 2016) study was conducted. Medline, Embase and PubMed were searched for randomised controlled trials published between 1 January 2014 and 19 March 2020. Studies had to report IOP reduction after 3 months for at least two different treatments among placebo, PGAs (bimatoprost 0.01%, bimatoprost 0.03%, latanoprost, LBN, tafluprost, unoprostone) or apraclonidine, betaxolol, brimonidine, brinzolamide, carteolol, dorzolamide, levobunolol, timolol, travoprost. A Bayesian network meta-analysis was performed to provide the relative effect in terms of mean difference (95% credible interval) of IOP reduction and ranking probabilities. Surface under the cumulative ranking curve (SUCRA) was generated.
RESULTS
A total of 106 trials were included with data for 18 523 participants. LBN was significantly more effective than unoprostone (-3.45 (-4.77 to -2.12)). Although relative effect was not significative, compared with other PGAs, LBN numerically outperformed latanoprost (-0.70 (-1.83 to 0.43)) and tafluoprost (-0.41 (-1.87 to 1.07)), was similar to bimatoprost 0.01% (-0.02(-1.59 to 1.55)) and was slightly disadvantaged by bimatoprost 0.03% (-0.17 (-1.42 to 1.07)). LBN was significantly more efficient than the beta-blockers apraclonidine, betaxolol, brimonidine, brinzolamide, carteolol, dorzolamide and timolol. According to SUCRA, LBN was ranked second after bimatoprost 0.03%, followed by bimatoprost 0.01%.
CONCLUSION
LBN was significantly more effective than the PGA unoprostone and most of the beta-blockers. Compared with the most widely used PGAs, LBN numerically outperformed latanoprost and travoprost and was similar to bimatoprost 0.01%.
背景/目的：评估新型前列腺素类似物拉坦前列素苯丁酯（LBN）与其他治疗开角型青光眼和高眼压症的药物相比，在降低眼内压（IOP）方面的比较疗效。
方法
对 Li（Ophthalmology，2016）研究的系统文献综述进行了改编。检索了 Medline、Embase 和 PubMed 数据库，以获取 2014 年 1 月 1 日至 2020 年 3 月 19 日期间发表的随机对照试验。研究必须报告至少两种不同治疗方案（安慰剂、PGAs[比马前列素 0.01%、比马前列素 0.03%、拉坦前列素、LBN、他氟前列素、乌诺前列酮]或阿可乐定、倍他洛尔、溴莫尼定、布林佐胺、卡替洛尔、多佐胺、左布诺洛尔、噻吗洛尔、曲伏前列素）与 PGA（比马前列素 0.01%、比马前列素 0.03%、拉坦前列素、LBN、他氟前列素、乌诺前列酮）或阿可乐定、倍他洛尔、溴莫尼定、布林佐胺、卡替洛尔、多佐胺、左布诺洛尔、噻吗洛尔、曲伏前列素）相比，IOP 降低 3 个月后至少两种不同治疗方案的降 IOP 效果。使用贝叶斯网络荟萃分析（Bayesian network meta-analysis）提供 IOP 降低的平均差异（95%可信区间）的相对效果，并进行排序概率分析。生成累积排序曲线下面积（SUCRA）。
结果
共纳入 106 项试验，共计 18523 名参与者。LBN 与乌诺前列酮相比，降眼压效果显著（-3.45[-4.77 至-2.12]）。尽管相对效果不显著，但与其他前列腺素类似物相比，LBN 数值上优于拉坦前列素（-0.70[-1.83 至 0.43]）和他氟前列素（-0.41[-1.87 至 1.07]），与比马前列素 0.01%相似（-0.02[-1.59 至 1.55]），略逊于比马前列素 0.03%（-0.17[-1.42 至 1.07]）。LBN 与β-受体阻滞剂阿可乐定、倍他洛尔、溴莫尼定、布林佐胺、卡替洛尔、多佐胺和噻吗洛尔相比，降眼压效果显著。根据 SUCRA，LBN 仅次于比马前列素 0.03%，排名第二，其次是比马前列素 0.01%。
结论
LBN 与前列腺素类似物乌诺前列酮和大多数β-受体阻滞剂相比，降眼压效果显著。与最广泛使用的前列腺素类似物相比，LBN 数值上优于拉坦前列素和曲伏前列素，与比马前列素 0.01%相似。
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