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北欧国家年龄相关性黄斑变性中地图状萎缩的患病率和潜在适合接受玻璃体内补体抑制剂治疗的患者数量:系统评价、荟萃分析和预测研究。

Prevalence of geographic atrophy in Nordic countries and number of patients potentially eligible for intravitreal complement inhibitor treatment: A systematic review with meta-analyses and forecasting study.

机构信息

Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark.

Department of Ophthalmology, Odense University Hospital, Odense, Denmark.

出版信息

Acta Ophthalmol. 2023 Dec;101(8):857-868. doi: 10.1111/aos.15768. Epub 2023 Sep 8.

Abstract

We systematically reviewed the literature on the prevalence of geographic atrophy (GA) in Nordic populations, conducted meta-analyses on age-stratified estimates, and calculated current and future number of patients and those potentially eligible for intravitreal complement inhibitor treatment. We followed the PRISMA guidelines, and our protocol was registered in PROSPERO. Ten databases were searched on 22 April 2023 for population-based studies of GA prevalence. Based on clinical descriptive analyses of GA and eligibility criteria of the phase III studies for intravitreal pegcetacoplan (complement C3 and C3b inhibitor), we were able to calculate the proportion of patients with GA potentially eligible for therapy. Finally, we extracted population data for Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) from Eurostat, applied prevalence statistics to the extracted census and forecasting data to estimate the number of patients with GA, and then applied the proportion eligible for intravitreal pegcetacoplan therapy. We identified six studies with a total of 10 159 individuals. Prevalence of GA was estimated to 0.4% (95% confidence intervals [CI]: 0.2%-0.8%), 1.5% (95% CI: 0.7%-2.6%), and 7.6% (95% CI: 4.6%-11.3%) for individuals aged 60-69, 70-79, and 80+ years, respectively. In Nordic countries, we estimate a total of 166 307 individuals with GA in 2023, increasing to 277 893 in 2050. Of these, 90 803 individuals in 2023, increasing to 151 730 in 2050, are potentially eligible for intravitreal complement inhibitor treatment. Considering these large numbers, our study highlights the importance of this topic in the coming years and its potential to significantly impact our clinical practice, organization, and staffing.

摘要

我们系统地回顾了北欧人群中地图萎缩(GA)患病率的文献,对年龄分层估计进行了荟萃分析,并计算了当前和未来的患者人数以及潜在符合玻璃体腔补体抑制剂治疗条件的患者人数。我们遵循 PRISMA 指南,我们的方案已在 PROSPERO 注册。我们于 2023 年 4 月 22 日在 10 个数据库中搜索了关于 GA 患病率的基于人群的研究。基于 GA 的临床描述性分析以及玻璃体腔内培格司亭(补体 C3 和 C3b 抑制剂)III 期研究的入选标准,我们能够计算出潜在符合治疗条件的 GA 患者比例。最后,我们从 Eurostat 提取了北欧国家(丹麦、芬兰、冰岛、挪威和瑞典)的人口数据,将患病率统计数据应用于提取的人口普查和预测数据,以估计 GA 患者人数,然后应用玻璃体腔内培格司亭治疗的入选比例。我们确定了六项共涉及 10159 人的研究。60-69 岁、70-79 岁和 80 岁及以上人群中 GA 的患病率估计分别为 0.4%(95%置信区间[CI]:0.2%-0.8%)、1.5%(95%CI:0.7%-2.6%)和 7.6%(95%CI:4.6%-11.3%)。在北欧国家,我们估计 2023 年共有 166307 人患有 GA,到 2050 年将增加到 277893 人。其中,2023 年有 90803 人(到 2050 年将增加到 151730 人)潜在符合玻璃体腔补体抑制剂治疗条件。考虑到这些庞大的数字,我们的研究强调了这个话题在未来几年的重要性,以及它对我们的临床实践、组织和人员配备可能产生的重大影响。

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