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雷珠单抗治疗早产儿视网膜病变:系统评价与荟萃分析。

Ranibizumab for the treatment of retinopathy of prematurity: systematic review and meta-analysis.

作者信息

Alva Niza, Martínez Alex R, Ortiz-Saavedra Brando, Montes-Madariaga Elizbet S, Cotrina Alonso, Caballero-Alvarado José A, Sah Ranjit, Barboza Joshuan J

机构信息

Facultad de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.

Unidad de Revisiones Sistemáticas y Meta-Análisis, Tau-Relaped Group, Lima, Peru.

出版信息

Front Pediatr. 2023 Aug 4;11:1202927. doi: 10.3389/fped.2023.1202927. eCollection 2023.

Abstract

UNLABELLED

Anti-VEGF drugs like ranibizumab can be used to treat retinopathy of prematurity (ROP) by halting the formation of abnormal blood vessels, or lasers can be used to burn the edges of the retina where these vessels are present. The objective is to compare the efficacy for ROP between ranibizumab and laser therapy.

MATERIAL AND METHODS

Electronic searches will be carried out in medical databases with key words and controlled vocabulary terms. Randomized controlled trials (RCT) will be assessed. The primary outcome will be the full ROP regression. Two reviewers will extract the data using predefined forms and, to assess the quality of the study, we will use RoB 2.0, the tool for randomized controlled trials developed by the Cochrane Collaboration. We used a combination of the inverse-variance approach and random-effects models for the meta-analysis.

RESULTS

The eyes of 182 preterm infants who had ranibizumab treatment were assessed in a total of 364 eyes, and 135 infants received laser therapy. The follow-up period was between 6 and 24 months. Ranibizumab was not associated with greater regression of ROP compared to laser therapy in preterm infants (RR: 1.09, CI 95%: 0.95-1.24; : 0.22). Also, ranibizumab was not associated with recurrence of ROP compared to laser therapy in preterm infants (RR: 3.77, CI 95%: 0.55-25.81; : 0.22).

CONCLUSIONS

The efficacy of ranibizumab compared to laser is very uncertain in terms of ROP regression and decreased ROP recurrence in preterm infants.

SYSTEMATIC REVIEW REGISTRATION

identifier PROSPERO (CRD42022324150).

摘要

未标注

像雷珠单抗这样的抗血管内皮生长因子(VEGF)药物可通过阻止异常血管的形成来治疗早产儿视网膜病变(ROP),或者也可以使用激光烧灼存在这些血管的视网膜边缘。目的是比较雷珠单抗与激光治疗对ROP的疗效。

材料与方法

将在医学数据库中使用关键词和控制词汇术语进行电子检索。将评估随机对照试验(RCT)。主要结局将是ROP完全消退。两名评价者将使用预定义表格提取数据,并且为了评估研究质量,我们将使用Cochrane协作网开发的随机对照试验工具RoB 2.0。我们在荟萃分析中使用了逆方差法和随机效应模型的组合。

结果

共有364只眼睛评估了182名接受雷珠单抗治疗的早产儿的眼睛,135名婴儿接受了激光治疗。随访期为6至24个月。与激光治疗相比,雷珠单抗在早产儿中与ROP更大程度的消退无关(风险比:1.09,95%置信区间:0.95 - 1.24;P = 0.22)。此外,与激光治疗相比,雷珠单抗在早产儿中与ROP复发无关(风险比:3.77,95%置信区间:0.55 - 25.81;P = 0.22)。

结论

就早产儿ROP消退和降低ROP复发而言,雷珠单抗与激光相比的疗效非常不确定。

系统评价注册

标识符PROSPERO(CRD42022324150)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/124b/10436596/d162e2e08133/fped-11-1202927-g001.jpg

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