康柏西普对比雷珠单抗治疗年龄相关性黄斑变性的meta分析

Conpercept Versus Ranibizumab in the Treatment of Age-related Macular Degeneration: A Meta-analysis

关键词:  康柏西普  雷珠单抗  年龄相关性黄斑变性  meta分析

Key words:  conpercept  ranibizumab  age-related macular degeneration  meta-analysis

摘要:

目的 通过分析康柏西普和雷珠单抗治疗年龄相关性黄斑变性（age-related macular degeneration，AMD）的相关文献，为临床AMD指导用药提供依据。方法 通过Pubmed、The Cochrane Library、Web of Science及万方科技期刊数据库、中国知网、中国生物医学文献数据库、重庆维普中文科技期刊全文数据库检索有关玻璃体腔注射康柏西普和雷珠单抗的临床随机对照试验文献，并对纳入文献进行风险评估，提取文献中相关指标，采用Revman 5.3软件进行数据分析，应用随机或固定效应模型分析异质性，同时绘制漏斗型图，检测发表偏倚。结果 共纳入符合条件文献15篇，合计940例患者。康柏西普组和雷珠单抗组在黄斑中心凹视网膜厚度（central macular of retinal thickness，CRT）[WMD=-4.78，95%CI（-11.63，2.07），P=0.17]和最佳矫正视力（best corrected visual acuity，BCVA）[WMD=-0.02，95%CI（-0.03，0.00），P=0.07]方面差异无统计学意义；康柏西普组在脉络膜新生血管（corneal neovascularization，CNV）渗漏面积上优于雷珠单抗组[WMD=-0.98，95%CI（-1.22，-0.73），P<0.000 01]，差异有统计学意义。结论 康柏西普和雷珠单抗对AMD疗效相当，均可改善患眼BCVA，降低CRT以及抑制CNV渗漏，此外，康柏西普在控制渗漏面积方面均有一定治疗优势。

Abstract:

OBJECTIVE To provide the basis for clinical guidance of age-related macular degeneration(AMD) drugs, the efficacy of conpercept and ranibizumab against AMD was compared by systematic review. METHODS Relevant randomized control trials about conpercept versus ranibizumab were identified by searching electronic databases including Pubmed, The Cochrane Library, Web of Science, Wanfang data, CNKI, CBM and VIP Database. RevMan 5.3 software was used for relevant index data analysis. Random and fixed effect models were employed to evaluate heterogeneity, funnel plots were also used to detect the publication bias. RESULTS A total of 15 studies, involving 940 patients were included of meta-analysis. There was no difference of central macular of retinal thickness(CRT)[WMD=-4.78, 95%CI(-11.63, 2.07), P=0.17], and best corrected visual acuity(BCVA)[WMD=-0.02, 95%CI(-0.03, 0.00), P=0.07] between the 2 groups, while leakage area of corneal neovascularization (CNV) in conpercept group was better than ranibizumab group[WMD=-0.98, 95%CI(-1.22, -0.73), P<0.000 01], the difference was significant. CONCLUSION Conpercept and ranibizumab have the similar therapeutic effect on AMD. They both can improve BCVA, reduce CRT and inhibit the leakage area of CNV, while conpercept has a certain therapeutic advantage in controlling the leakage area of CNV.