Liu Kexin, Yi Jinyang, Xu Juan, Zhong Li, Su Na
Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China.
Department of Pharmacy, Suining First People's Hospital, Suining, China.
PLoS One. 2025 Jan 24;20(1):e0317782. doi: 10.1371/journal.pone.0317782. eCollection 2025.
There is different administration routes of triamcinolone acetonide (TA) administration for macular edema, but the efficacy ranking remains unclear. The purpose of this study is to assess the efficacy of different administration routes of TA employed in macular edema. PubMed, Medline, Embase, and Cochrane Central Register of Controlled Trials were systematically searched for published articles comparing macular edema in patients with triamcinolone acetonide in different administration. The sparse network was evaluated using a random-effects model and consistency model within the Bayesian framework, utilizing the multinma package in R. The evidence was assessed based on the Grading of Recommendations. Assessment, Development, and Evaluation (GRADE) criteria. A total of 1138 citations were identified by our search, of which 20 RCTs enrolled 892 eyes. The network showed that intravitreal triamcinolone acetonide (IVTA) was associated with a statistically significant better best corrected visual acuity (BCVA) at the 12th week compared to placebo (MD: - 0.15, 95% CI: - 0.30 to - 0.01, P < 0.05), which was moderate-quality evidence. IVTA and suprachoroidal triamcinolone acetonide (SCTA) were both associated with a statistically significant reduction in central macular thickness (CMT) at the 12th week, which was moderate evidence. The probabilities of rankings and SUCRA demonstrated that sub-Tenon's infusion of triamcinolone acetonide (STiTA) might be the worst. SCTA and IVTA were proven to be the best administration routes for improving BCVA and reducing CMT. In addition, STiTA was less advisable than other administration routes of triamcinolone acetonide according to the rankings and SUCRA.
曲安奈德(TA)治疗黄斑水肿有不同的给药途径,但疗效排名仍不明确。本研究的目的是评估TA不同给药途径治疗黄斑水肿的疗效。系统检索了PubMed、Medline、Embase和Cochrane对照试验中央注册库,以查找比较不同给药方式下曲安奈德治疗黄斑水肿患者的已发表文章。在贝叶斯框架内,使用随机效应模型和一致性模型,利用R中的multinma软件包评估稀疏网络。根据推荐分级评估、制定和评价(GRADE)标准对证据进行评估。我们的检索共识别出1138条引文,其中20项随机对照试验纳入了892只眼。网络显示,与安慰剂相比,玻璃体内注射曲安奈德(IVTA)在第12周时最佳矫正视力(BCVA)有统计学意义的显著改善(MD:-0.15,95%CI:-0.30至-0.01,P<0.05),这是中等质量的证据。IVTA和脉络膜上腔注射曲安奈德(SCTA)在第12周时均与中心黄斑厚度(CMT)有统计学意义的显著降低相关,这是中等证据。排名概率和累积排序曲线下面积(SUCRA)表明,Tenon囊下注射曲安奈德(STiTA)可能是最差的。SCTA和IVTA被证明是改善BCVA和降低CMT的最佳给药途径。此外,根据排名和SUCRA,STiTA比曲安奈德的其他给药途径更不可取。