التفاصيل البيبلوغرافية
| العنوان: |
PROMJENA INHIBITORA VASKULARNOG ENDOTELNOG FAKTORA RASTA U LIJEČENJU VLAŽNOG OBLIKA SENILNE MAKULARNE DEGENERACIJE: META-ANALIZA I PREGLED LITERATURE. (Bosnian) |
| العنوان البديل: |
CHANGE OF VASCULAR ENDOTHELIAL GROWTH FACTOR INHIBITOR IN THE TREATMENT OF WET FORM OF SENILE MACULAR DEGENERATION: META-ANALYSIS AND LITERATURE REVIEW. (English) |
| المؤلفون: |
OPAČIĆ, DALIBOR, VUKOJEVIĆ, ANTE, ŠKEGRO, BERNARDA, ŠKEGRO, IVAN, MANDIĆ, KREŠIMIR, ŠTANFEL, MARIJA, JUKIĆ, TOMISLAV |
| المصدر: |
Acta Medica Croatica; 2020, Vol. 74 Issue 3, p229-236, 8p |
| مصطلحات موضوعية: |
ENDOTHELIAL growth factors, TREATMENT effectiveness, RETINAL degeneration, VISUAL acuity, VASCULAR endothelial growth factors |
| الملخص (بالإنجليزية): |
The aim was to perform a systematic review and meta-analysis of scientific papers that analyzed treatment outcome in patients with exudative age-related macular degeneration after therapeutic switch from bevacizumab/ranibizumab to afl ibercept. Pubmed (Medline) and Science Citation Index expanded databases were searched over the last 5 years, with a combination of keywords. Clear criteria were defined, and evaluation of the best corrected visual acuity, with measurement of the central macular thickness by ocular coherence tomography before and after drug conversion was performed. Two meta-analyses have been published in recent literature analyzing studies with the results of treatment of resistant senile macular degeneration by conversion to afl ibercept, with somewhat similar inclusion criteria, the most important of which is the minimum six-month follow-up of patients after conversion therapy. The fi rst meta-analysis included 7 and the second 28 studies, prospective and retrospective. Both meta-analyses showed a significant improvement in the central macular thickness after conversion to afl ibercept, while the improvement in visual acuity was very modest in one and unchanged in the other. Thus, a change in drug significantly improved the anatomic outcome; however, no significant improvement in visual function was observed. The reason is chronic illness and impairment, which implies a limited potential for vision recovery. Similar to the results of the previously mentioned meta-analyses, our analysis showed that improvement in the anatomic structure of the macula can be achieved by changing therapy. Finally, eleven of twenty studies that investigated the outcome of conversion from one anti-vascular endothelial growth factor drug to another were included in meta-analysis. The results showed a statistically significant decrease in macular thickness after conversion to afl ibercept in all studies (overall significance level p<0.001). The analysis performed showed a significantly improved anatomic outcome, but visual improvement was found to be modest in only a few studies. This result could probably be explained by the fact that a longlasting chronic disease causes irreversible damage and prevents significant functional recovery. Prospective studies with uniformly defined input criteria would allow better comparison of the results obtained after change in the treatment. [ABSTRACT FROM AUTHOR] |
| Abstract (Bosnian): |
Cilj: Provesti sustavni pregled i meta-analizu znanstvenih radova koji su analizirali ishod liječenja u bolesnika s eksudativnom degeneracijom makule povezane s dobi nakon terapijskog prelaska s bevacizumaba / ranibizumaba na afl ibercept. Materijali i metode: Pretražene su proširene baze podataka Pubmed (Medline) i Science Citation Index u posljednjih 5 godina, uz kombinaciju ključnih riječi. Definirani su jasni kriteriji i istražene su najbolje korigirane oštrine vida, uz mjerenje središnje debljine makule pomoću koherencijske tomografi je očiju prije i nakon promjene lijeka. Rasprava: U nedavno objavljenim publikacijama koje su analizirale rezultate liječenja rezistentne senilne degeneracije makule konverzijom na afl ibercept objavljene su dvije meta-analize, sa sličnim kriterijima uključivanja, od kojih je najvažniji najmanje šestomjesečno praćenje bolesnika nakon terapijske konverzije. Prva meta-analiza uključivala je 7, a druga 28 studija, prospektivnih i retrospektivnih. Obje meta-analize pokazale su značajno poboljšanje središnje debljine makule nakon prelaska na afl ibercept, dok je poboljšanje oštrine vida u jednoj skromno, a u drugoj nepromijenjeno. Tako je promjena lijeka značajno poboljšala anatomski ishod; međutim, nije primijećeno značajno poboljšanje vidne funkcije. Razlog je kronicitet bolesti i posljedično oštećenje, što podrazumijeva ograničenu mogućnost za oporavak vida. Naša analiza pokazala je, slično rezultatima prethodno spomenutih meta-analiza, da se promjenom terapije može postići poboljšanje anatomske strukture makule. U završnici je u meta-analizu uključeno jedanaest od dvadeset studija koje su istraživale ishod konverzije jednog lijeka protiv vaskularnog endotelnog faktora rasta na drugi lijek. Rezultati su pokazali statistički značajno smanjenje debljine makule nakon konverzije na afl ibercept u svim studijama (ukupna razina značajnosti p <0,001). Zaključci: Provedena analiza pokazala je značajno poboljšan anatomski ishod, ali je skromno poboljšanje vida nađeno u samo nekoliko studija. Taj se rezultat vjerojatno može objasniti činjenicom da dugotrajna kronična bolest uzrokuje nepovratna oštećenja i sprečava značajan funkcionalni oporavak. Prospektivne studije s jednako definiranim ulaznim kriterijima omogućile bi bolju usporedbu rezultata liječenja dobivenih nakon promjene lijeka. [ABSTRACT FROM AUTHOR] |
|
Copyright of Acta Medica Croatica is the property of Croatian Academy of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Supplemental Index |
