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法西单抗继发于抗血管内皮生长因子药物治疗新生血管性年龄相关性黄斑变性患者的疗效:一项系统评价和荟萃分析。

Efficacy of faricimab secondary to anti-vascular endothelial growth factor agents in patients with neovascular age-related macular degeneration: a systematic review and meta-analysis.

作者信息

Jin Eric, Chan Adrian Cy, Thomas George N

机构信息

Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Department of Ophthalmology, National University Hospital, Singapore, Singapore.

出版信息

Eye (Lond). 2025 Aug 20. doi: 10.1038/s41433-025-03943-7.

Abstract

This study examines the efficacy and safety of faricimab as a secondary treatment for neovascular age-related macular degeneration (nAMD) patients previously treated with anti-vascular endothelial growth factors (anti-VEGF) agents. A literature search was performed on PubMed, EMBASE, and Cochrane Library up to 24 October 2024. Cohort and observational studies reporting functional and anatomical outcomes in nAMD patients switched to faricimab were included. Meta analysis with common and random-effect model was performed using "metagen" package in R version 3.2.1. 446 studies were identified on our preliminary search, of which 20 studies (1007 eyes) with a baseline central macular thickness (CMT) of 342.07 ( ± 110.14) um were included in the final analysis. Switching to faricimab led to significant reductions in CMT at 3 months (Mean difference = -47.08 um, 95% Confidence Interval (CI)= (-66.01, -28.15), p = 0.009) and 6 months post-switch (Mean difference =-44.68 um, 95% CI= (-67.17, -22.20), p = 0.002). Pigment epithelium detachment (PED) height was also reduced at 3 months (Mean difference = -31.71um, 95% CI= (-45.12, -18.30), p = 0.036) and 6 months post-switch (Mean difference = -34.85 um, 95% CI= (-50.19, -19.51), p = 0.011). However, no significant improvements in best corrected visual acuity (BCVA) were observed at 3 months (p = 0.407), 6 months (p = 0.920) or ≥12 months (p = 0.261) post-switch. Treatment intervals were significantly extended (Mean difference=1.87 weeks, 95% CI = (0.41, 33.3), p = 0.019), with a low incidence of serious adverse events. In conclusion, faricimab demonstrates favorable structural benefits, stable functional outcomes and extended treatment intervals as a second-line treatment for nAMD in patients with prior anti-VEGF therapy.

摘要

本研究探讨了法西单抗作为二线治疗药物,用于曾接受抗血管内皮生长因子(anti-VEGF)药物治疗的新生血管性年龄相关性黄斑变性(nAMD)患者的疗效和安全性。截至2024年10月24日,我们在PubMed、EMBASE和Cochrane图书馆进行了文献检索。纳入了报告转换为法西单抗治疗的nAMD患者功能和解剖学结果的队列研究和观察性研究。使用R 3.2.1版本中的“metagen”软件包进行固定效应模型和随机效应模型的Meta分析。在初步检索中识别出446项研究,最终分析纳入了20项研究(1007只眼),其基线中心黄斑厚度(CMT)为342.07(±110.14)μm。转换为法西单抗治疗后,3个月时CMT显著降低(平均差=-47.08μm,95%置信区间(CI)=(-66.01,-28.15),p = 0.009),转换后6个月时也显著降低(平均差=-44.68μm,95%CI=(-67.17,-22.20),p = 0.002)。色素上皮脱离(PED)高度在转换后3个月(平均差=-31.71μm,95%CI=(-45.12,-18.30),p = 0.036)和6个月时(平均差=-34.85μm,95%CI=(-50.19,-19.51),p = 0.011)也有所降低。然而,转换后3个月(p = 0.407)、6个月(p = 0.920)或≥12个月(p = 0.261)时,最佳矫正视力(BCVA)均未观察到显著改善。治疗间隔显著延长(平均差=1.87周,95%CI =(0.41,3.33),p = 0.019),严重不良事件发生率较低。总之,对于先前接受过抗VEGF治疗的nAMD患者,法西单抗作为二线治疗药物显示出良好的结构改善效果、稳定的功能结果以及延长的治疗间隔。

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