康柏西普和雷珠单抗治疗视网膜静脉阻塞继发黄斑水肿有效性的Meta分析

Systematic evaluation of the efficacy of Conbercept and Ranibizumab in the treatment of macular edema secondary to retinal vein occlusion

目的:系统评价康柏西普和雷珠单抗治疗视网膜静脉阻塞(RVO)继发黄斑水肿(ME)的疗效、安全性、经济性。方法:分别在万方数据库、中国生物医学文献服务系统、中国知网、Pubmed、The Cochrane Library Central Register of Controlled Trials(CENTRAL)、Google scholar等数据库收集自建库至2020-02-20关于康柏西普和雷珠单抗治疗RVO继发ME的对照研究,提取最佳矫正视力、黄斑中心凹视网膜厚度、不良反应发生情况、注射次数等主要结局指标进行系统评价,比较二者的效果。采用RevMan 5.3统计软件进行数据的分析。结果:共纳入16项研究,合计患者1337例。Meta分析结果提示,与雷珠单抗相比,康柏西普在采用1+PRN注射方案和治疗视网膜分支静脉阻塞(BRVO)继发ME患者时,对黄斑水肿的消退效果更明显,但二者注射次数无明显差异;与雷珠单抗相比,康柏西普在采用3+PRN注射方案和治疗视网膜中央静脉阻塞(CRVO)继发ME患者时,注射次数更少;康柏西普和雷珠单抗在视力改善和不良反应的发生方面无明显差异。结论:与雷珠单抗相比,康柏西普在不同的注射方案和不同的静脉阻塞类型治疗中体现出更优的效果,即更少的注射次数或更好的黄斑水肿消退效果。

AIM:To evaluate the efficacy,safety and economy of conbercept and ranibizumab in the treatment of macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:The comparative studies on macular edema secondary to RVO were collected in Wanfang database,CNKI,Pubmed,The Cochrane Library,Google scholar and other databases.The best corrected visual acuity,macular fovea retinal thickness,the number of adverse reactions and the number of injections were systematically evaluated.Compare the effects of the two.RevMan 5.3 statistical software was used to analyze the data.RESULTS:A total of 1337 patients were included in 16 studies.The results of systematic evaluation showed that in 1+PRN injection regimen and in the treatment of BRVO secondary ME patients,the regression effect of ME was more obvious,and the injection times were less in 3+PRN injection regimen and treatment of CRVO secondary ME patients.In comparison with the effect of ranibizumab,there was no significant difference in the improvement of visual acuity and the occurrence of side effects when 3+PRN injection was used to treat ME secondary to CRVO.When 1+PRN injection was used to treat Brvo secondary ME,the total number of injections was not statistically significant.CONCLUSION:Compared with ranibizumab,conbercept showed better effect in different injection regimens and different types of vein occlusion that is less injection times or better ME regression effect.