Efficacy and Safety of Anti-VEGF Drugs for Neovascular Age-Related Macular Degeneration Therapy: Systematic Review and Meta-Analysis

Speaker(s)

Klabukova D1, Krysanova V2, Krysanov I1, Kurkin D1, Kolosov Y1, Ermakova V3, Makarova E4
1Russian University of Medicine, Moscow, MOW, Russia, 2Medical Institute of Continuing Education, BIOTECH University, Moscow, Russian Federation, 3Sechenov First Moscow State Medical University, Moscow, Russian Federation, 4Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain

Presentation Documents

OBJECTIVES: Neovascular age-related macular degeneration (nAMD) is a prognostically unfavorable form of disease, associated with neovascularization and often leads to vision loss and disability. First line of nAMD treatment is intravitreal injections of anti-vascular endothelial growth factors (anti-VEGF) drugs. A novel bispecific monoclonal antibody targeting simultaneously VEGF-A and angiopoietin-2 pathways is faricimab. The aim of the study was to perform an indirect comparison of the efficacy and safety of faricimab and other anti-VEGF drugs for nAMD.

METHODS: We conducted a systematic review via PRISMA guideline among randomized controlled trials (RCTs) published before November 2022. For the network meta-analysis (NMA) we selected RCTs with data on six efficacy and safety results for 12 months of therapy. Fixed effect models were consistent for changes from baseline in best-corrected visual acuity (BCVA), central retinal thickness (CRT), number of injections and letter category (patients gaining / losing ETDRS letter visual acuity) outcomes. Random effect models were selected for incidence of adverse events and treatment discontinuation. NMA methodology included the forest plots with 95% CI calculation for faricimab 6 mg up to one injection in 16 weeks (Q8-16W) compared with aflibercept 2 mg and ranibizumab 0.5 mg in various fixed, pro re nata and treat-and-extend regimens.

RESULTS: Of the 3172 initial publications, we assessed 238 publications for eligibility and considered 28 studies for inclusion in the NMA. The core network was formed from 19 RCTs. Faricimab 6 mg Q8-16W is associated with comparable or even superior visual (BCVA change) and anatomical (CRT reduction) outcomes per year of therapy with a lower injection frequency than aflibercept 2 mg or ranibizumab 0.5 mg in various regimens. Faricimab has similar safety profile of ocular adverse events to other angiogenesis inhibitors.

CONCLUSIONS: Clinical efficacy and safety of faricimab and other anti-VEGF drugs are comparable in patients with nAMD.

Code

SA106

Topic

Clinical Outcomes, Study Approaches

Topic Subcategory

Comparative Effectiveness or Efficacy, Literature Review & Synthesis, Meta-Analysis & Indirect Comparisons

Disease

Drugs, Geriatrics, Sensory System Disorders (Ear, Eye, Dental, Skin)