Evidence map›Paper›PMID 28123287›Full record

ReviewClinical ophthalmology (Auckland, N.Z.)2017

Switching to aflibercept among patients with treatment-resistant neovascular age-related macular degeneration: a systematic review with meta-analysis.

Kimberly Spooner, Thomas Hong, Wijeyanthy Wijeyakumar, Andrew A Chang

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Clinical ophthalmology (Auckland, N.Z.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Kimberly SpoonerSydney Retina Clinic & Day Surgery; Sydney Institute of Vision Science, Sydney; Save Sight Institute, Department of Ophthalmology, University of Sydney, Camperdown, NSW, Australia.
Thomas HongSydney Retina Clinic & Day Surgery; Sydney Institute of Vision Science, Sydney.
Wijeyanthy WijeyakumarSydney Retina Clinic & Day Surgery; Sydney Institute of Vision Science, Sydney; Save Sight Institute, Department of Ophthalmology, University of Sydney, Camperdown, NSW, Australia.
Andrew A ChangSydney Retina Clinic & Day Surgery; Sydney Institute of Vision Science, Sydney; Save Sight Institute, Department of Ophthalmology, University of Sydney, Camperdown, NSW, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo systematically review anatomical and functional outcomes subsequent to switching from bevacizumab/ranibizumab to aflibercept monotherapy in patients with treatment-resistant neovascular age-related macular degeneration (nAMD).

designSystematic review and meta-analysis.

methodsMedline, PubMed, Embase, and Cochrane databases were searched up to July 2016 for available scientific literature which met inclusion criteria. Eligible studies reported visual and anatomical outcomes with at least 6 months of follow-up among patients with nAMD and persistent or resistant exudative fluid despite previous anti-vascular endothelial growth factor (VEGF) therapy (bevacizumab and/or ranibizumab) and were switched to aflibercept monotherapy. Mean changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were pooled using random-effects models with 95% confidence intervals (CIs).

resultsOf 82 papers reviewed, 28 studies met inclusion criteria of this review. Pooled results showed a small mean improvement in BCVA at 6 and 12 months following switching (1.11 letters, 95% CI -0.25 to 2.46,

conclusionPooled analysis demonstrated significantly improved anatomical outcomes; however, visual function remained stable, having a comparable effect to other anti-VEGF agents in preservation of vision. These patients had poorly responsive chronic disease with limited potential for visual recovery. Switching to aflibercept with frequent monitoring may be a suitable option for patients who have developed treatment resistance.

Indexed as

afliberceptanti-vascular endothelial growth factormacular degenerationmeta-analysistreatment resistance

Identifiers

PMID28123287
PMCPMC5229260

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.