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雷珠单抗对早产儿视网膜病变的影响:一项荟萃分析。

Effect of ranibizumab on retinopathy of prematurity: A meta-analysis.

作者信息

Wang Zhibin, Zhang Zhaobo, Wang Yue, Di Yu

机构信息

Department of Ophthalmology, Shengjing Hospital of China Medical University, Shenyang China.

Department of Cardiology, First Hospital of China Medical University, Shenyang, China.

出版信息

Front Pharmacol. 2022 Aug 22;13:897869. doi: 10.3389/fphar.2022.897869. eCollection 2022.

Abstract

The primary objective of this study was to systematically evaluate the clinical efficacy of intravitreal ranibizumab injection in the treatment for retinopathy of prematurity (ROP) in infants. The MEDLINE (PubMed), Embase, China Biology Medicine disc, Cochrane Library, Web of Science, WanFang Data, CNKI, and CQVIP databases were searched to collect randomized controlled trials (RCTs) comparing the efficacy of ranibizumab with laser treatment in ROP. The retrieval time was from 2007, on which ranibizumab was approved until 12 January 2022. Data were extracted based on predetermined inclusion and exclusion criteria. Two investigators employed QUADAS-2 to independently assess the quality of all eligible original studies. Following quality evaluation, we also performed a meta-analysis using STATA v 15.1 and RevMan v 5.4 and funnel plots were used to detect publication bias. A total of five RCTs were included in the meta-analysis. In this study, the regression rate of retinal neovascularization was used as the index of therapeutic effectiveness. According to the results, the retinal neovascularization regression rate of the intravitreal ranibizumab injection group was statistically higher than that of the laser therapy group [risk ratio (RR) = 1.26, 95% confidence interval (CI): 1.18-1.35]; however, the incidence of adverse events, including recurrence and complications, was not different between them (RR = 0.73, 95%CI: 0.19-2.80). Therefore, intravitreal ranibizumab injection may be more clinically effective than laser therapy in the treatment for ROP. The safety and efficacy of ranibizumab in the long-term treatment for ROP needs further investigation. : https://www.crd.york.ac.uk/prospero/, CRD42022296387.

摘要

本研究的主要目的是系统评价玻璃体内注射雷珠单抗治疗婴儿早产儿视网膜病变(ROP)的临床疗效。检索MEDLINE(PubMed)、Embase、中国生物医学光盘数据库、Cochrane图书馆、科学网、万方数据、中国知网和维普数据库,以收集比较雷珠单抗与激光治疗ROP疗效的随机对照试验(RCT)。检索时间为2007年(雷珠单抗获批时间)至2022年1月12日。根据预先设定的纳入和排除标准提取数据。两名研究人员采用QUADAS-2独立评估所有符合条件的原始研究的质量。质量评估后,我们还使用STATA v 15.1和RevMan v 5.4进行了荟萃分析,并使用漏斗图检测发表偏倚。荟萃分析共纳入五项RCT。本研究中,视网膜新生血管消退率用作治疗效果指标。结果显示,玻璃体内注射雷珠单抗组的视网膜新生血管消退率在统计学上高于激光治疗组[风险比(RR)=1.26,95%置信区间(CI):1.18-1.35];然而,包括复发和并发症在内的不良事件发生率在两组之间无差异(RR=0.73,95%CI:0.19-2.80)。因此,玻璃体内注射雷珠单抗治疗ROP可能比激光治疗更具临床疗效。雷珠单抗治疗ROP的长期安全性和疗效需要进一步研究。:https://www.crd.york.ac.uk/prospero/,CRD42022296387

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aea6/9441804/03fda88dfa2e/fphar-13-897869-g001.jpg

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