Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados

Respuestas clínicas Cochrane

Topics

Temas

Study flow diagram.
Figuras y tablas -
Figure 1

Study flow diagram.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Forest plot of comparison: 1 Aflibercept vs ranibizumab, outcome: 1.1 Mean change in BCVA in ETDRS letters at 1 year.
Figuras y tablas -
Figure 3

Forest plot of comparison: 1 Aflibercept vs ranibizumab, outcome: 1.1 Mean change in BCVA in ETDRS letters at 1 year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Forest plot of comparison: 1 Aflibercept vs ranibizumab, outcome: 1.2 Gain of ≥ 15 letters of BVCA at 1 year.
Figuras y tablas -
Figure 4

Forest plot of comparison: 1 Aflibercept vs ranibizumab, outcome: 1.2 Gain of ≥ 15 letters of BVCA at 1 year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Forest plot of comparison: 1 Aflibercept vs ranibizumab, outcome: 1.4 Absence of fluid on optical coherence tomography (OCT) at 1 year.
Figuras y tablas -
Figure 5

Forest plot of comparison: 1 Aflibercept vs ranibizumab, outcome: 1.4 Absence of fluid on optical coherence tomography (OCT) at 1 year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Forest plot of comparison: 1 Aflibercept vs ranibizumab, outcome: 1.7 Mean change in vision‐related quality‐of‐life scores at 1 year.
Figuras y tablas -
Figure 6

Forest plot of comparison: 1 Aflibercept vs ranibizumab, outcome: 1.7 Mean change in vision‐related quality‐of‐life scores at 1 year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Aflibercept vs ranibizumab, Outcome 1 Mean change in BCVA in ETDRS letters at 1 year.
Figuras y tablas -
Analysis 1.1

Comparison 1 Aflibercept vs ranibizumab, Outcome 1 Mean change in BCVA in ETDRS letters at 1 year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Aflibercept vs ranibizumab, Outcome 2 Gain of ≥ 15 letters of BVCA at 1 year.
Figuras y tablas -
Analysis 1.2

Comparison 1 Aflibercept vs ranibizumab, Outcome 2 Gain of ≥ 15 letters of BVCA at 1 year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Aflibercept vs ranibizumab, Outcome 3 Loss of ≥ 15 letters of BVCA at 1 year.
Figuras y tablas -
Analysis 1.3

Comparison 1 Aflibercept vs ranibizumab, Outcome 3 Loss of ≥ 15 letters of BVCA at 1 year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Aflibercept vs ranibizumab, Outcome 4 Absence of fluid on optical coherence tomography (OCT) at 1 year.
Figuras y tablas -
Analysis 1.4

Comparison 1 Aflibercept vs ranibizumab, Outcome 4 Absence of fluid on optical coherence tomography (OCT) at 1 year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Aflibercept vs ranibizumab, Outcome 5 Mean change in size of the choroidal neovascularization at 1 year.
Figuras y tablas -
Analysis 1.5

Comparison 1 Aflibercept vs ranibizumab, Outcome 5 Mean change in size of the choroidal neovascularization at 1 year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Aflibercept vs ranibizumab, Outcome 6 Mean change in central retinal thickness at 1 year.
Figuras y tablas -
Analysis 1.6

Comparison 1 Aflibercept vs ranibizumab, Outcome 6 Mean change in central retinal thickness at 1 year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Aflibercept vs ranibizumab, Outcome 7 Mean change in vision‐related quality‐of‐life scores at 1 year.
Figuras y tablas -
Analysis 1.7

Comparison 1 Aflibercept vs ranibizumab, Outcome 7 Mean change in vision‐related quality‐of‐life scores at 1 year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Aflibercept vs ranibizumab, Outcome 8 Adverse events ‐ arterial thrombotic events at 1 year.
Figuras y tablas -
Analysis 1.8

Comparison 1 Aflibercept vs ranibizumab, Outcome 8 Adverse events ‐ arterial thrombotic events at 1 year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Aflibercept vs ranibizumab, Outcome 9 Adverse events ‐ serious systemic events at 1 year.
Figuras y tablas -
Analysis 1.9

Comparison 1 Aflibercept vs ranibizumab, Outcome 9 Adverse events ‐ serious systemic events at 1 year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Aflibercept vs ranibizumab, Outcome 10 Adverse events ‐ serious ocular events at 1 year.
Figuras y tablas -
Analysis 1.10

Comparison 1 Aflibercept vs ranibizumab, Outcome 10 Adverse events ‐ serious ocular events at 1 year.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Aflibercept vs ranibizumab for neovascular age‐related macular degeneration

Patient or population: people with age‐related macular degeneration

Settings: clinical centers

Intervention: intravitreal injections of aflibercept

Comparison: intravitreal injections of ranibizumab

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Ranibizumab

Aflibercept

Mean change in BCVA in ETDRS letters at 1 year

(number of letters)

Mean change in visual acuity across ranibizumab groups ranged from gains of 8.57 letters to 8.71 letters

Mean change in visual acuity in aflibercept groups was on average 0.15 fewer letters gained (95% CI 1.47 fewer letters to 1.17 more letters)

MD ‐0.15
(‐1.47 to 1.17)

2412
(2)

⊕⊕⊕⊕
High

Gain of ≥ 15 letters of BVCA at 1 year

324 per 1000

314 per 1000
(275 to 360)

RR 0.97
(0.85 to 1.11)

2412

(2)

⊕⊕⊕⊕
High

Absence of fluid on optical coherence tomography (OCT) at 1 year

595 per 1000

630 per 1000
(583 to 678)

RR 1.06
(0.98 to 1.14)

2291

(2)

⊕⊕⊕⊕
High

Quality‐of‐life measures at 1 year

(National Eye Institute‐Visual Function Questionnaire [NEI‐VFQ])

Mean improvement in composite NEI‐VQF score ranged across control groups from 4.9 to 6.3 points

Mean improvement in composite NEI‐VQF score in intervention groups was on average 0.39 points lower (95% CI 1.71 points lower to 0.93 points higher)

MD ‐0.39
(‐1.71 to 0.93)

2412

(2)

⊕⊕⊕⊕
High

Adverse events ‐ serious systemic events at 1 year

139 per 1000

138 per 1000
(110 to 174)

RR 0.99 (0.79 to 1.25)

2419

(2)

⊕⊕⊕⊝
Moderatea

Adverse events ‐ serious ocular events at 1 year

32 per 1000

20 per 1000
(12 to 34)

RR 0.62 (0.36 to 1.07)

2419

(2)

⊕⊕⊕⊝
Moderatea

*The basis for the assumed risk (eg, median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). The unit of analysis is the individual (one study eye per person).
CI: Confidence interval; RR: Risk ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate
Very low quality: We are very uncertain about the estimate

aAdverse events downgraded to moderate quality as the number of events is small (wide confidence intervals)

Figuras y tablas -
Ir a la tabla de la revisión
Comparison 1. Aflibercept vs ranibizumab

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mean change in BCVA in ETDRS letters at 1 year Show forest plot

2

2412

Mean Difference (IV, Fixed, 95% CI)

‐0.15 [‐1.47, 1.17]

2 Gain of ≥ 15 letters of BVCA at 1 year Show forest plot

2

2412

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.85, 1.11]

3 Loss of ≥ 15 letters of BVCA at 1 year Show forest plot

2

2412

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.61, 1.30]

4 Absence of fluid on optical coherence tomography (OCT) at 1 year Show forest plot

2

2291

Risk Ratio (M‐H, Fixed, 95% CI)

1.06 [0.98, 1.14]

5 Mean change in size of the choroidal neovascularization at 1 year Show forest plot

2

2412

Mean Difference (IV, Fixed, 95% CI)

‐0.24 [‐0.78, 0.29]

6 Mean change in central retinal thickness at 1 year Show forest plot

2

2412

Mean Difference (IV, Fixed, 95% CI)

‐4.94 [‐15.48, 5.61]

7 Mean change in vision‐related quality‐of‐life scores at 1 year Show forest plot

2

2412

Mean Difference (IV, Fixed, 95% CI)

‐0.39 [‐1.71, 0.93]

8 Adverse events ‐ arterial thrombotic events at 1 year Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

8.1 Any Antiplatelet Trialists' Collaboration arterial thrombolytic event

2

2419

Risk Ratio (M‐H, Fixed, 95% CI)

1.04 [0.52, 2.11]

8.2 Vascular death

2

2419

Risk Ratio (M‐H, Fixed, 95% CI)

1.47 [0.32, 6.78]

8.3 Non‐fatal myocardial infarction

2

2419

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.32, 2.09]

8.4 Non‐fatal stroke

2

2419

Risk Ratio (M‐H, Fixed, 95% CI)

1.11 [0.27, 4.50]

9 Adverse events ‐ serious systemic events at 1 year Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

9.1 Any serious systemic adverse event

2

2419

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.79, 1.25]

9.2 Congestive heart failure event

2

2419

Risk Ratio (M‐H, Fixed, 95% CI)

0.77 [0.20, 2.97]

9.3 Non‐ocular hemorrhagic event

2

2419

Risk Ratio (M‐H, Fixed, 95% CI)

2.30 [0.42, 12.70]

10 Adverse events ‐ serious ocular events at 1 year Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

10.1 Any serious ocular adverse event

2

2419

Risk Ratio (M‐H, Fixed, 95% CI)

0.62 [0.36, 1.07]

10.2 Visual acuity reduced

2

2419

Risk Ratio (M‐H, Fixed, 95% CI)

1.08 [0.30, 3.93]

10.3 Retinal hemorrhage

2

2419

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.16, 2.60]
Figuras y tablas -
Comparison 1. Aflibercept vs ranibizumab
Ir a la tabla de la revisión