中国药房2025，Vol.36Issue(8)：996-1000,5.DOI:10.6039/j.issn.1001-0408.2025.08.19
抗VEGF药物治疗糖尿病性黄斑水肿的系统评价再评价
Overview of systematic evaluation of anti-VEGF drugs in the treatment of diabetic macular oedema
摘要
Abstract
OBJECTIVE To re-evaluate the use of systematic evaluation/meta-analysis of anti-VEGF drugs in the treatment of diabetic macular oedema(DME),aiming to provide evidence-based support for the clinical application of this medication.METHODS A comprehensive search was conducted across a range of databases,including CNKI,Wanfang data,VIP,CBM,PubMed,Web of Science,Embase,and Cochrane Library.The objective was to identify systematic evaluation/meta-analysis of anti-VEGF drugs for DME,with search time from the inception of the databases to March 2024.The report quality,methodological quality,and evidence quality were assessed by using PRISMA2020 statement,AMSTAR2 scale and GRADE tool.A comprehensive analysis of systematic evaluation/meta-analysis results was also conducted.RESULTS A total of 22 articles were included.According to the PRISMA2020 statement evaluation,13 studies provided relatively complete information(≥21 points),while 9 studies had information deficiencies(18-＜21 points).The AMSTAR 2 scale evaluation revealed that 21 studies had very low methodological quality,and one study had low methodological quality.The GRADE tool evaluation showed that out of 89 outcome indicators,28(31.46%)were classified as high-quality evidence,34(38.20%)as moderate-quality evidence,24(26.97%)as low-quality evidence,and 3(3.37%)as very low-quality evidence.The comprehensive quality analysis results demonstrated that,compared with laser photocoagulation,anti-VEGF drugs significantly enhanced the improvement in best-corrected visual acuity(BCVA),as well as significant change in retinal thickness at 1 and 6 months,and 1 and 2 years post-treatment,and also in BCVA and retinal thickness at 1,3,and 6 months post-treatment(P＜0.05).Compared with placebo,patients treated with anti-VEGF drugs showed significant improvement in BCVA after 1 year of treatment(P＜0.05).However,when compared with corticosteroid drugs,patients treated with anti-VEGF drugs exhibited a significant increase in retinal thickness after 6 months of treatment(P＜0.05).Compared with corticosteroid drugs,the incidence of adverse events related to the eyes,cataract formation and intraocular pressure were significantly decreased in patients treated with anti-VEGF drugs(P＜0.05).Compared with laser photocoagulation,the incidence of ocular adverse events was significantly decreased in patients treated with anti-VEGF drugs,while the incidence of fatal adverse events was significantly increased(P＜0.05).CONCLUSIONS Anti-VEGF therapy for DME may possess certain advantages in terms of efficacy and safety,but it is associated with a higher risk of fatal adverse events;the evidence included in systematic reviews/meta-analyses is of moderate to high quality.关键词
抗血管内皮生长因子药物/糖尿病性黄斑水肿/疗效/安全性/系统评价再评价Key words
anti-vascular endothelial growth factor drugs/diabetic macular oedema/efficacy/safety/overview of systematic evaluation分类
药学引用本文复制引用
关婧楠,宗庸央措,令娟,沈鲜艳,李孟翰,陈绪帆,梁永林,张定华..抗VEGF药物治疗糖尿病性黄斑水肿的系统评价再评价[J].中国药房,2025,36(8):996-1000,5.基金项目
国家自然科学基金项目(No.82460897) （No.82460897）
甘肃中医药大学研究生"创新创业基金"项目(No.甘中医大研发[2024]48号) （No.甘中医大研发[2024]48号）
