补充抑制剂用于与年龄相关的黄斑变性
Nikolaos Tzoumas1,2, George Riding1,3, Michael A Williams4
1Biosciences Institute, Newcastle University, Newcastle-upon-Tyne, UK.
The Cochrane database of systematic reviews
|June 14, 2023
概括
补充抑制剂,如佩格塞塔科普兰,在减缓与年龄相关的黄斑变性 (AMD) 的地理缩 (GA) 进展方面表现有希望. 然而,这些治疗方法并不能改善视力敏度,并且可能增加其他眼睛疾病的风险.
科学领域:
- 眼科医生 眼科 眼科
- 免疫学 免疫学 免疫学
- 遗传学 是一个遗传学.
背景情况:
- 与年龄相关的黄斑变性 (AMD) 是全球视力丧失的主要原因,在老年人群中发病率越来越高.
- 补充系统的过度活动被认为是AMD发展和进展的关键驱动因素.
- 针对AMD治疗的补充通路的新疗法正在出现.
研究的目的:
- 评估补充剂抑制剂用于预防或治疗晚期AMD的疗效和安全性.
- 评估补充剂抑制对视觉敏度,病变进展和不良事件的影响.
主要方法:
- 随机对照试验 (RCT) 的系统综述和元分析,涉及高级AMD的补充抑制剂.
- 搜索了多个数据库直到2022年6月,包括Cochrane图书馆,MEDLINE和clinicalTrials.gov.gov.
- 包括10个RCT与4052名参与者,评估内 (IVT) 和静脉注射药物与假药或安慰剂.
主要成果:
- 与假药相比,静脉内甲基可普兰有意义地减少了地理缩 (GA) 病变的生长19.2% (每月) 和14.8% (每隔一个月).
- 内中avacincaptad pegol可能会减少GA病变的生长 (25.6 - 30.5%),特别是在外/右病例中.
- 没有补充抑制剂显示出最佳校正视敏度 (BCVA) 的有意义改善;观察到黄斑新血管化 (MNV) 和内炎的潜在风险增加.
结论:
- 静脉内甲基和avacincaptad pegol显示出减缓GA进展的潜力,但在晚期的AMD中没有改善视觉功能.
- 补充抑制可能与新出现的风险有关,包括MNV和内炎的小风险.
- 需要进一步的研究来确定这些疗法的最佳剂量,长期疗效,安全性和成本效益.
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