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Combination of bevacizumab and photodynamic therapy vs. bevacizumab monotherapy for the treatment of wet age‑related macular degeneration: A meta‑analysis of randomized controlled trials

  • Authors:
    • Qingquan Wei
    • Junling Liu
    • Qingyu Liu
    • Chengda Ren
    • Wenting Cai
    • Xiuwei Liang
    • Jing Wen
    • Jing Yu

  • View Affiliations

  • Published online on: June 13, 2018     https://doi.org/10.3892/etm.2018.6305
  • Pages: 1187-1194

  • Copyright: © Wei et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The purpose of this meta‑analysis was to compare the efficacy and safety of the combination of bevacizumab and photodynamic therapy (PDT) with bevacizumab monotherapy for the treatment of age‑related macular degeneration (AMD). Patients with active choroidal neovascularization (CNV) secondary to AMD were included in the present study. The treatment group included patients treated with a combination of bevacizumab and PDT and patients treated with bevacizumab monotherapy. Only randomized controlled trials (RCTs) were included in the analysis. The PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases were searched. Meta‑analysis was performed using RevMan v.5.3 software, and best‑corrected visual acuity (BCVA), central retinal thickness (CRT) and the average number of bevacizumab retreatments were assessed. A total of 5 RCTs were included in the analysis. There were no significant differences observed in the mean BCVA change between the combination treatment group and the bevacizumab monotherapy group [standard mean difference 0.20; 95% confidence interval (CI) ‑0.53, 0.93, P=0.59]. There were also no significant differences in the CRT increases between the two groups [weighted mean difference (WMD) ‑22.16, 95% CI ‑52.01 to 7.69, P=0.15]. No significant differences were observed in the proportions of patients gaining >15 letters between the two groups [risk ratio (RR) 0.86, 95% CI 0.64, 1.15, P=0.30]. However, the average number of the ranibizumab retreatments was significantly lower in the combination treatment group compared with the bevacizumab monotherapy group (WMD, ‑2.70, 95% CI ‑3.93 to ‑1.46; P<0.0001). Additionally, there were no significant differences in the rate of ocular adverse events (RR, 0.57; 95% CI, 0.27 to 1.22; P=0.15) and systemic adverse events (RR, 5.42; 95% CI, 0.29 to 101.77; P=0.26) between the two groups. In conclusion there were no significant differences in mean BCVA change, CRT increases, the proportions of patients gaining >15 letters, or the incidences of ocular adverse events and systemic adverse events. However, combination treatment may significantly reduce the average number of bevacizumab retreatments compared with monotherapy.
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August-2018
Volume 16 Issue 2

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Wei Q, Liu J, Liu Q, Ren C, Cai W, Liang X, Wen J and Yu J: Combination of bevacizumab and photodynamic therapy vs. bevacizumab monotherapy for the treatment of wet age‑related macular degeneration: A meta‑analysis of randomized controlled trials. Exp Ther Med 16: 1187-1194, 2018
APA
Wei, Q., Liu, J., Liu, Q., Ren, C., Cai, W., Liang, X. ... Yu, J. (2018). Combination of bevacizumab and photodynamic therapy vs. bevacizumab monotherapy for the treatment of wet age‑related macular degeneration: A meta‑analysis of randomized controlled trials. Experimental and Therapeutic Medicine, 16, 1187-1194. https://doi.org/10.3892/etm.2018.6305
MLA
Wei, Q., Liu, J., Liu, Q., Ren, C., Cai, W., Liang, X., Wen, J., Yu, J."Combination of bevacizumab and photodynamic therapy vs. bevacizumab monotherapy for the treatment of wet age‑related macular degeneration: A meta‑analysis of randomized controlled trials". Experimental and Therapeutic Medicine 16.2 (2018): 1187-1194.
Chicago
Wei, Q., Liu, J., Liu, Q., Ren, C., Cai, W., Liang, X., Wen, J., Yu, J."Combination of bevacizumab and photodynamic therapy vs. bevacizumab monotherapy for the treatment of wet age‑related macular degeneration: A meta‑analysis of randomized controlled trials". Experimental and Therapeutic Medicine 16, no. 2 (2018): 1187-1194. https://doi.org/10.3892/etm.2018.6305