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Comparative Efficacy and Acceptability of Pharmacological Treatments for Ischaemic Optic Neuropathy: A
Qianxiong He1,2,3
1Center for Infectious Diseases, Hunan University of Medicine General Hospital, Huaihua, Hunan, China.
Abstract:
Many medicines are ineffective in the treatment of ischaemic optic neuropathy (ION). The effects of all ten medicines for the treatment of ION were assessed through a meta-analysis using direct and indirect comparisons of multiple treatments. This systematic review of nine randomised controlled trials (1,012 participants) from April 1994 to May 2022 compared the efficacy of placebo (PLA), ranibizumab (RAN), dexamethasone (DEX), prednisolone (PRE), oxygen (OX), troxerutin (TRO), RPh201, erythropoietin (ERY), levodopa + carbidopa (LEV+CAR), and prednisolone + ranitidine (PRE+RA) for the treatment of ION. The primary measure of success was the percentage of patients who either responded to the treatment or discontinued the study. Intention-to-treat analysis was conducted. DEX, PRE, OX, TRO, ERY, LEV+CAR, and PRE+RA were significantly more effective than PLA (odds ratios (ORs) 43.64, 1.19, 1.17, 4.22, 2.64, 3.32, and 1.10, respectively). RAN was significantly more effective than DEX (OR 1.67). RPh201 is significantly less effective than all other medicines. Acceptance of PLA was good. RAN and DEX are the best options for treating ION. Therefore, these results should be considered in clinical practice. Key Words: Ischaemic optic neuropathy, Meta-analysis, Treatment.
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