背景:年龄相关性黄斑变性(AMD)被认为是老年人视力丧失的主要原因。考虑到全球老龄化社会的现象,AMD的患病率有望在未来逐渐增加。AMD可以分为早期,中间,后期阶段,早期和中期主要是无症状的,晚期被归类为地理萎缩,新生血管性AMD,或者两者兼而有之。目前新生血管性AMD的药物治疗包括抗血管内皮生长因子药物,比如雷珠单抗,pegaptanib,和自由。此外,有报道称,玻璃体内给予贝伐单抗的超说明书使用是有效的.它的成本也比其他代理商低,这使得它成为一种有趣的药理学方法。
目的:这篇综述旨在评估疗效,安全,贝伐单抗治疗新生血管性AMD的有效性。
方法:本综述将仅考虑随机对照临床试验,比较贝伐单抗与另一种药物或安慰剂在50岁及以上被诊断为血管性AMD的患者中的应用。它将排除包括诊断为息肉状脉络膜血管病变或视网膜血管瘤增生的参与者的研究。要识别和选择相关文章,我们将开发高度敏感的搜索策略,并通过PubMed平台将其应用于MEDLINE。在选择研究和分析标题后,摘要,和全文,结果将根据系统评价和荟萃分析(PRISMA)指南的首选报告项目进行介绍。数据的分析和提取将由2名独立审稿人进行。偏差风险将通过关键评估技能计划(CASP)清单进行评估。最后,同样的审稿人还将对纳入的研究进行质量评估,并对建议进行分级,评估,发展,和评估(等级)工具。
结果:搜索策略,纳入和排除标准应用后,确定了15项随机临床试验,目前正在分析。该项目没有资金,由药理学家和骨科医师组成的多学科研究小组开发。该研究于2021年5月启动,预计将于2023年底结束。
结论:本综述将提供关于在新生血管性AMD中使用贝伐单抗的最新信息和潜在证据的综合。它将为可能的新药理学方法提供更清晰的视野,以及最合适的治疗设计,用于治疗新生血管性AMD。
背景:PROSPEROCRD42021244931;https://tinyurl.com/p6m5ycpk.
■DERR1-10.2196/38658。
BACKGROUND: Age-related macular degeneration (AMD) is recognized as the leading cause of vision loss in older people. Considering the phenomenon of aging societies worldwide, the prevalence of AMD is expected to increase gradually in the future. AMD can be divided into early, intermediate, and late stages, with the early and intermediate stages being mainly asymptomatic, and the late stage being classified as geographic atrophy, neovascular AMD, or both. Current pharmacological treatments for neovascular AMD include anti-vascular endothelial growth factor agents, such as ranibizumab, pegaptanib, and aflibercept. Additionally, it has been reported that the off-label use of intravitreally administered bevacizumab is effective. It is also lower cost than other agents, which makes it an interesting pharmacological approach.
OBJECTIVE: This
review aims to evaluate the efficacy, safety, and efficiency of bevacizumab for the treatment of neovascular AMD.
METHODS: This
review will only consider randomized controlled clinical trials that compare the use of bevacizumab with another pharmacological agent or a placebo in patients aged 50 years and older who are diagnosed with vascular AMD. It will exclude studies that include participants diagnosed with polypoidal choroidal vasculopathy or retinal angiomatous proliferation. To identify and select relevant articles, we will develop a highly sensitive search strategy and apply it in MEDLINE via the PubMed platform. Upon selection of the studies and analysis of the titles, abstracts, and full texts, the results will be presented according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The analysis and extraction of the data will be performed by 2 independent reviewers. Risk of bias will be evaluated with the Critical Appraisal Skills Programme (CASP) checklist. Finally, the same reviewers will also perform a quality assessment of the included studies with the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tool.
RESULTS: The search strategy, after the application of the inclusion and exclusion criteria, identified 15 randomized clinical trials, which are currently being analyzed. This project has no funding and it has been developed by a multidisciplinary research team of pharmacologists and orthoptists. The study was initiated in May 2021 and it is expected to conclude by the end of 2023.
CONCLUSIONS: This
review will provide a synthesis of current information and underlying evidence about the off-label use of bevacizumab in neovascular AMD. It will provide a clearer vision of a possible new pharmacological approach, as well as the most suitable treatment designs, for the treatment of neovascular AMD.
BACKGROUND: PROSPERO CRD42021244931; https://tinyurl.com/p6m5ycpk.
UNASSIGNED: DERR1-10.2196/38658.