Evidence map›Paper›PMID 39612949›Full record

Trial reportOphthalmology2025

Macular Edema Ranibizumab versus Intravitreal Anti-inflammatory Therapy Trial: 24-Week Outcomes of Uveitic Macular Edema Re-treatment.

Multicenter Uveitis Steroid Treatment Trial (MUST) Research Group, John Gonzales, Nisha R Acharya, Elizabeth A Sugar, Alyce E Burke, Albert T Vitale, Vishali Gupta, James P Dunn, Susan L Lightman, Jennifer E Thorne and 6 more

Abstract readRandomized Controlled TrialMulticenter StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. Review
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

16 authors.

Multicenter Uveitis Steroid Treatment Trial (MUST) Research Group
John GonzalesFrancis. I. Proctor Foundation, University of California, San Francisco, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, San Francisco, California.
Nisha R AcharyaFrancis. I. Proctor Foundation, University of California, San Francisco, San Francisco, California; Department of Ophthalmology, University of California, San Francisco, San Francisco, California; Departments of Epidemiology, University of California, San Francisco, San Francisco, California.
Elizabeth A SugarCenter for Clinical Trials and Evidence Synthesis, Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Biostatistics, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Alyce E BurkeCenter for Clinical Trials and Evidence Synthesis, Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Albert T VitaleDepartment of Ophthalmology, University of Utah, Salt Lake City, Utah.
Vishali GuptaAdvanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
James P DunnRetina Division, Wills Eye Hospital, Department of Ophthalmology, Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania.
Susan L LightmanUniversity of College London, Institute of Ophthalmology, Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom; Institute of Ophthalmology, University College London, London, United Kingdom.
Jennifer E ThorneCenter for Clinical Trials and Evidence Synthesis, Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Rosa Y KimRetina Consultants of Texas, Houston, Texas.
Steven YehTruhlsen Eye Institute, Department of Ophthalmology, University of Nebraska, Omaha, Nebraska.
Michael M AltaweelThe Wisconsin Reading Center, Department of Ophthalmology and Visual Sciences and McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
John H KempenDepartment of Ophthalmology and Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; MCM Eye Unit, MCM Comprehensive Specialized Hospital and Myungsung Medical College, Addis Ababa, Ethiopia; Department of Ophthalmology, Addis Ababa University School of Medicine, Addis Ababa, Ethiopia; Sight for Souls, Bellevue, Washington.
Janet T HolbrookCenter for Clinical Trials and Evidence Synthesis, Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Douglas A JabsCenter for Clinical Trials and Evidence Synthesis, Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: djabs@jhmi.edu.

Funding

Macular Edema Treatment Trials Associated with MUST (META-MUST)U10EY024527 · NEI · JOHNS HOPKINS UNIVERSITY · PI HOLBROOK, JANET T. · 2014 to 2019
$8.3M
MACULAR EDEMA TREATMENT TRIALS ASSOCIATED WITH MUST (META-MUST)U10EY024526 · NEI · JOHNS HOPKINS UNIVERSITY · PI JABS, DOUGLAS A · 2014 to 2018
$1.9M
Macular Edema Treatment Trials Associated with MUST (META-MUST)U10EY024531 · NEI · UNIVERSITY OF WISCONSIN-MADISON · PI ALTAWEEL, MICHAEL M · 2014 to 2018
$1.1M
NEI NIH HHS U10 EY024526NEI NIH HHS U10 EY024527NEI NIH HHS U10 EY024531
6 · The paper itself

Abstract

purposeEvaluation of longer-term effectiveness of 3 intravitreal therapies (methotrexate, ranibizumab, or dexamethasone implant) for participants enrolled in the randomized comparative effectiveness trial the Macular Edema Ranibizumab versus Intravitreal Anti-inflammatory Therapy (MERIT) Trial followed up for 24 weeks.

designMulticenter randomized controlled clinical trial with masked evaluation of retinal thickness and visual acuity.

participantsPatients with persistent or recurrent uveitic macular edema.

methodsParticipants from 33 centers were randomized 1:1:1 (stratified by presence or absence of concomitant systemic immunosuppression for uveitis) to receive a sequence of intravitreal treatments with dexamethasone implant, methotrexate, or ranibizumab. Participants with bilateral macular edema received the same treatment bilaterally. During 24 weeks of follow-up, nonassigned treatments were permitted beginning from 12 weeks for those meeting re-treatment criteria.

main outcome measuresCentral subfield thickness (CST) change from baseline OCT measurement was the main outcome. Secondary outcomes included change in mean standard letters of baseline best-corrected visual acuity (BCVA). Analyses were conducted according to 2 principles: (1) as assigned, in which outcomes were analyzed according to their original randomized treatment, and (2) a supplementary censored analysis, in which data were excluded after an eye received a nonassigned treatment.

resultsAmong 194 enrolled participants (225 eligible eyes), 177 participants (207 eyes) completed 24 weeks of follow-up. Eyes assigned to methotrexate (55%) and ranibizumab (37%) more frequently received nonassigned treatments (88% dexamethasone implant or intravitreal corticosteroid injection) compared with eyes assigned to dexamethasone (7%). In the as-assigned analysis, dexamethasone showed superior improvement in macular edema compared with ranibizumab (CST, 34% vs. 19%; P = 0.01), but not compared with methotrexate (CST, 31%; P = 0.59) after being superior to both other regimens at 12 weeks. However, in the censored analysis, only dexamethasone was associated with improvements in macular edema (CST, 34% vs 8% [P < 0.001] and 5% [P < 0.001]) and BCVA improvement of > 5 letters compared with methotrexate and ranibizumab, respectively. Dexamethasone more often was associated with intraocular pressure elevations of ≥ 24 mmHg (32%) and of ≥ 30 mmHg (10%).

conclusionsDexamethasone was more effective than methotrexate and ranibizumab for the treatment of persistent or recurrent uveitic macular edema through 24 weeks, with manageable side effects. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Indexed as

Angiogenesis InhibitorsDexamethasoneGlucocorticoidsMacular EdemaMethotrexateRanibizumabUveitisAdultAgedDrug ImplantsFemaleFollow-Up StudiesHumansIntravitreal InjectionsMaleMiddle AgedAngiogenesis InhibitorsDexamethasoneDrug ImplantsGlucocorticoidsMethotrexateRanibizumabVascular Endothelial Growth Factor AVEGFA protein, humanIntravitreal therapyMacular edemaRandomized controlled clinical trialUveitis

Identifiers

PMID39612949
PMCPMC12018142

What OpenQuestion holds

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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.