Evidence map›Paper›PMID 28238195›Full record

Trial reportGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2017

Switching therapy from bevacizumab to aflibercept for the management of persistent diabetic macular edema.

Bobak Bahrami, Thomas Hong, Meidong Zhu, Timothy E Schlub, Andrew Chang

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed
–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

26 citing papers in PubMed.

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  13. Effects of Intravitreal Bevacizumab Therapy in Patients with Proliferative Diabetic Retinopathy.Diabetes, metabolic syndrome and obesity : targets and therapy · 2020
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  17. Reply to the letter to the editor: Aflibercept in diabetic macular edema refractory to previous bevacizumab: outcomes and predictors of success.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2018
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  20. Aflibercept in diabetic macular edema refractory to previous bevacizumab: outcomes and predictors of success.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2018
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Bobak BahramiSydney Institute of Vision Science, 13/187 Macquarie Street, Sydney, New South Wales, 2000, Australia.
Thomas HongSydney Institute of Vision Science, 13/187 Macquarie Street, Sydney, New South Wales, 2000, Australia.
Meidong ZhuSydney Institute of Vision Science, 13/187 Macquarie Street, Sydney, New South Wales, 2000, Australia.
Timothy E SchlubSydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Andrew ChangSydney Institute of Vision Science, 13/187 Macquarie Street, Sydney, New South Wales, 2000, Australia. achang@sydneyretina.com.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the visual and anatomical outcomes following switching therapy from bevacizumab to aflibercept in patients with persistent diabetic macular edema (DME).

methodsPatients with DME and central macular thickness (CMT) >300 μm on spectral domain optical coherence tomography (SD-OCT) despite at least 4 intravitreal bevacizumab injections in the prior 6 months were recruited for this prospective, single-armed, single centre, open-label clinical trial. Five loading doses of intravitreal aflibercept were administered every 4 weeks until week 16, at which point the treatment interval was extended to 8 weeks. All participants were reviewed every 4 weeks. At each visit, examination included best-corrected visual acuity (BCVA) measured with an Early Treatment of Diabetic Retinopathy Study chart and CMT measured with SD-OCT. Primary outcome measures were change in CMT and BCVA at week 24 compared with baseline.

resultsA total of 43 eyes from 43 patients were recruited for the study. At enrolment, study eyes had a mean ± standard deviation of 16.6 ± 11.5 previous intravitreal anti-VEGF injections over a period of 26.9 ± 23.8 months. Mean CMT reduced from 417 ± 91 μm at baseline to 380 ± 102 μm at 24 weeks (mean reduction 37 μm, p < 0.01). Mean BCVA improved from 67.8 ± 10.3 letters at baseline to 71.0 ± 10.1 letters at 24 weeks (mean 3.2 letter gain, p < 0.01). Eyes improving by ≥5 letters at 4 weeks following the first injection had improved vision outcomes at 24 weeks (6.8 ± 7.1 letters vs. 1.0 ± 4.7 letters, p < 0.01).

conclusionIntravitreal aflibercept was effective in improving anatomical and visual outcomes among patients with incomplete response to intravitreal bevacizumab with 24 weeks of follow up. CLINICAL

trial registrationACTRN12614001307695.

Indexed as

Visual AcuityAngiogenesis InhibitorsBevacizumabDiabetic RetinopathyDose-Response Relationship, DrugFemaleFluorescein AngiographyFollow-Up StudiesFundus OculiHumansIntravitreal InjectionsMacular EdemaMaleMiddle AgedProspective StudiesReceptors, Vascular Endothelial Growth FactorafliberceptAngiogenesis InhibitorsBevacizumabReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsVascular Endothelial Growth Factor AAfliberceptAnti-vascular endothelial growth factorBevacizumabDiabetic macular edemaSwitchTreatment resistant

Identifiers

PMID28238195

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.