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Efficacy and safety of faricimab for neovascular age-related macular degeneration: a systematic review and network meta-analysis.
Samacá-Samacá, Daniel; Hernández-Castillo, Claudia; Prieto-Pinto, Laura; Rodríguez, Francisco; Sardi, Carolina; Ocampo, Hugo; Kock, Joshua; Hernández, Fabián.
Afiliação
  • Samacá-Samacá D; Evidence Generation, Roche Colombia, Bogotá D.C, Colombia daniel.samaca@roche.com.
  • Hernández-Castillo C; Real World Insights, IQVIA Solutions, Bogotá D.C, Colombia.
  • Prieto-Pinto L; Evidence Generation, Roche Colombia, Bogotá D.C, Colombia.
  • Rodríguez F; FUNDONAL, Bogota, Colombia.
  • Sardi C; Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá D.C, Colombia.
  • Ocampo H; Instituto Nacional de Investigación en Oftalmología, Medellín, Colombia.
  • Kock J; Clínica de Oftalmología, Cali, Colombia.
  • Hernández F; Evidence Generation, Roche Colombia, Bogotá D.C, Colombia.
BMJ Open Ophthalmol ; 9(1)2024 Jul 23.
Article em En | MEDLINE | ID: mdl-39043575
ABSTRACT

OBJECTIVE:

To evaluate the efficacy and safety of faricimab compared with other anti-vascular endothelial growth factor (anti-VEGF) agents in treating neovascular age-related macular degeneration (nAMD) patients. METHODS AND

ANALYSIS:

A systematic review (SR) was conducted up to January 2023. Network meta-analyses (NMA) were performed, including sensitivity and subgroup analyses for naïve population. Outcomes included changes in visual acuity (Early Treatment of Diabetic Retinopathy Study [ETDRS] letters), anatomical changes, frequency of injections and adverse events. The Cochrane Collaboration guidelines and the Confidence in Network Meta-Analysis framework were used for the SR and the certainty of evidence, respectively.

RESULTS:

From 4128 identified records through electronic databases and complementary searches, 63 randomised controlled trials (RCTs) met the eligibility criteria, with 42 included in the NMA. Faricimab showed a significant reduction in the number of annual injections compared with most fixed and flexible anti-VEGF treatment regimens, while showing no statistically significant differences in visual acuity through ETDRS letter gain, demonstrating a comparable efficacy. Retinal thickness results showed comparable efficacy to other anti-VEGF agents, and inferior only to brolucizumab. Results also showed that more patients treated with faricimab were free from post-treatment retinal fluid compared with aflibercept every 8 weeks, and both ranibizumab and bevacizumab, in the fixed and pro re nata (PRN) assessed schedules. Faricimab showed a comparable safety profile regarding the risk of ocular adverse events and serious ocular adverse events (SOAE), except for the comparison with brolucizumab quarterly, in which faricimab showed a significant reduction for SOAE risk.

CONCLUSION:

Faricimab showed a comparable clinical benefit in efficacy and safety outcomes, with a reduction in annual injections compared with fixed and flexible anti-VEGF drug regimens, representing a valuable treatment option for nAMD patients. PROSPERO REGISTRATION NUMBER CRD42023394226.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Acuidade Visual / Inibidores da Angiogênese / Fator A de Crescimento do Endotélio Vascular / Degeneração Macular Exsudativa / Injeções Intravítreas / Metanálise em Rede Limite: Humans Idioma: En Revista: BMJ Open Ophthalmol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Acuidade Visual / Inibidores da Angiogênese / Fator A de Crescimento do Endotélio Vascular / Degeneração Macular Exsudativa / Injeções Intravítreas / Metanálise em Rede Limite: Humans Idioma: En Revista: BMJ Open Ophthalmol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Reino Unido