Cochrane · systematic review · CD005139
Anti‐vascular endothelial growth factor for neovascular age‐related macular degeneration
Solomon, SD, Lindsley, K, Vedula, SS, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
13
No studies
1
Included studies
NR
No studies 1 · 7.1%Ungraded 0 · 0%Very low 0 · 0%Low 0 · 0%Moderate 8 · 57.1%High 5 · 35.7%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlySummary of findings: anti‐VEGF treatment versus control
Population: people with neovascular age‐related macular degeneration
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Gain of 15 or more letters visual acuity at 1 year Summary of findings: anti‐VEGF treatment vs control | RR 4.19 [2.32, 7.55] | 6 studies · 2667 participants | Moderate Downgraded: imprecision |
Loss of fewer than 15 letters visual acuity at 1 year Summary of findings: anti‐VEGF treatment vs control | RR 1.4 [1.27, 1.55] | 6 studies · 2667 participants | High |
Mean change in visual acuity at 1 year (number of letters) Summary of findings: anti‐VEGF treatment vs control | no estimate extracted | 4 studies · 2508 participants | Moderate Downgraded: inconsistency |
Reduction in central retinal thickness at 1 year Summary of findings: anti‐VEGF treatment vs control | no estimate extracted | NR | No studies |
Mean change in vision‐related quality of life Summary of findings: anti‐VEGF treatment vs control | MD 6.69 [3.38, 9.99] | 2 studies · 1134 participants | Moderate Downgraded: imprecision |
Serious systemic adverse events at 1 year Summary of findings: anti‐VEGF treatment vs control | RR 0.17 [0.01, 4.24] | 6 studies · 2667 participants | Moderate |
Serious ocular adverse events at 1 year Summary of findings: anti‐VEGF treatment vs control | RR 0.52 [0.03, 8.25] | 6 studies · 2667 participants | Moderate |
Summary of findings: bevacizumab versus ranibizumab
Population: people with neovascular age‐related macular degeneration
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Gain of 15 or more letters visual acuity at 1 year Summary of findings: bevacizumab vs ranibizumab | RR 0.95 [0.81, 1.12] | 8 studies · 3144 participants | High |
Loss of fewer than 15 letters visual acuity at 1 year Summary of findings: bevacizumab vs ranibizumab | RR 1 [0.98, 1.02] | 8 studies · 3144 participants | High |
Mean change in visual acuity at 1 year (number of letters) Summary of findings: bevacizumab vs ranibizumab | no estimate extracted | 9 studies · 3190 participants | High |
Reduction in central retinal thickness at 1 year Summary of findings: bevacizumab vs ranibizumab | no estimate extracted | 6 studies · 2693 participants | High |
No problems in quality of life domains at 1 year Summary of findings: bevacizumab vs ranibizumab | RR 0.96 [0.9, 1.04] | 1 study · 548 participants | Moderate |
Serious systemic adverse events at 1 yearb Summary of findings: bevacizumab vs ranibizumab | RR 1.15 [0.99, 1.34] | 6 studies · 3365 participants | Moderate |
Serious ocular adverse events at 1 year Summary of findings: bevacizumab vs ranibizumab | RR 0.51 [0.05, 5.62] | 1670 participants | Moderate |
Summary of findings: bevacizumab versus ranibizumab
Population: people with neovascular age‐related macular degeneration
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Gain of 15 letters or more visual acuity at one year Summary of findings: bevacizumab vs ranibizumab | RR 0.9 [0.73, 1.11] | 6 studies · 2446 participants | High |
Loss of fewer than 15 letters visual acuity at one year Summary of findings: bevacizumab vs ranibizumab | RR 1 [0.98, 1.02] | 6 studies · 2446 participants | High |
Mean change in visual acuity at one year (number of letters) Summary of findings: bevacizumab vs ranibizumab | no estimate extracted | 6 studies · 2446 participants | High |
Reduction in central retinal thickness at one year Summary of findings: bevacizumab vs ranibizumab | no estimate extracted | 4 studies · 1995 participants | High |
No problems in quality of life domains at one year Summary of findings: bevacizumab vs ranibizumab | no estimate extracted | 1 study · 548 participants | Moderate |
Serious systemic adverse events at one year2 Summary of findings: bevacizumab vs ranibizumab | RR 1.27 [1.06, 1.52] | 4 studies · 2597 participants | Moderate |
Serious ocular adverse events at one year Summary of findings: bevacizumab vs ranibizumab | no estimate extracted | 1670 participants | Moderate |
Summary of findings: pegaptanib versus control
Population: people with neovascular age‐related macular degeneration
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Gain of 15 letters or more visual acuity at one year Summary of findings: pegaptanib vs control | RR 2.83 [1.23, 6.52] | 1 study · 1186 participants | High |
Loss of fewer than 15 letters visual acuity at one year Summary of findings: pegaptanib vs control | RR 1.24 [1.11, 1.39] | 1 study · 1186 participants | High |
Mean change in visual acuity at one year (number of letters) Summary of findings: pegaptanib vs control | MD 6.72 [4.43, 9.01] | 1 study · 1186 participants | High |
Reduction in central retinal thickness at one year Summary of findings: pegaptanib vs control | no estimate extracted | NR | No studies |
No problems in quality of life domains at one year Summary of findings: pegaptanib vs control | no estimate extracted | NR | No studies |
Serious systemic adverse events at one year Summary of findings: pegaptanib vs control | RR 1.25 [0.93, 1.7] | 1 study · 1190 participants | Moderate |
Serious ocular adverse events at one year Summary of findings: pegaptanib vs control | RR 3.84 [0.91, 16.2] | 1 study · 1190 participants | Moderate |
Summary of findings: ranibizumab versus control
Population: people with neovascular age‐related macular degeneration
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Gain of 15 letters or more visual acuity at one year Summary of findings: ranibizumab vs control | no estimate extracted | 3 studies · 1322 participants | Moderate |
Loss of fewer than 15 letters visual acuity at one year Summary of findings: ranibizumab vs control | RR 1.53 [1.41, 1.64] | 3 studies · 1322 participants | High |
Mean change in visual acuity at one year (number of letters) Summary of findings: ranibizumab vs control | MD 17.8 [15.95, 19.65] | 3 studies · 1322 participants | High |
Reduction in central retinal thickness at one year Summary of findings: ranibizumab vs control | no estimate extracted | NR | No studies |
Mean change in vision‐related quality of life Summary of findings: ranibizumab vs control | MD 6.69 [3.38, 9.99] | 2 studies · 1134 participants | Moderate |
Serious systemic adverse events at one year Summary of findings: ranibizumab vs control | no estimate extracted | 2 studies · 603 participants | Moderate |
Serious ocular adverse events at one year Summary of findings: ranibizumab vs control | no estimate extracted | 2 studies · 603 participants | Moderate |
Summary of findings: bevacizumab versus control
Population: people with neovascular age‐related macular degeneration
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Gain of 15 letters or more visual acuity at one year Summary of findings: bevacizumab vs control | RR 7.8 [2.44, 24.98] | 2 studies · 159 participants | Moderate |
Loss of fewer than 15 letters visual acuity at one year Summary of findings: bevacizumab vs control | RR 1.28 [1.09, 1.5] | 2 studies · 159 participants | Moderate |
Mean change in visual acuity at one year (number of letters) Summary of findings: bevacizumab vs control | no estimate extracted | NR | No studies |
Reduction in central retinal thickness at one year Summary of findings: bevacizumab vs control | no estimate extracted | NR | No studies |
Mean change in vision‐related quality of life Summary of findings: bevacizumab vs control | no estimate extracted | NR | No studies |
Serious systemic adverse events at one year Summary of findings: bevacizumab vs control | RR 2.03 [0.19, 21.85] | 1 study · 131 participants | Low |
Serious ocular adverse events at one year Summary of findings: bevacizumab vs control | RR 1.86 [0.73, 4.74] | 1 study · 131 participants | Low |