Evidence map›Paper›PMID 33434220›Full record

SynthesisPloS one2021

Intravitreal bevacizumab versus intravitreal triamcinolone for diabetic macular edema-Systematic review, meta-analysis and meta-regression.

Mohamed Abdel-Maboud, Esraa Menshawy, Eshak I Bahbah, Oumaima Outani, Amr Menshawy

Open access · goldAbstract readComparative StudyMeta-AnalysisSystematic Review
In one paragraph

Synthesis in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 16% of its field
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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Review
  5. Article
  6. Review
  7. Article
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

5 authors at 2 institutions in 2 countries.

Mohamed Abdel-MaboudFaculty of Medicine, Al-Azhar University, Cairo, Egypt.ORCID 0000-0002-7746-524X
Esraa MenshawyFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Eshak I BahbahFaculty of Medicine, Al-Azhar University, New Damietta, Egypt.
Oumaima OutaniFaculty of Medicine and Pharmacy of Rabat, Mohammed 5 University, Rabat, Morocco.
Amr MenshawyFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Al-Azhar University · EGMohammed V University · MA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe most frequent cause of vision loss from diabetic retinopathy is diabetic macular edema (DME). Earlier clinical trials tried to examine the role of intravitreal triamcinolone (IVT) and intravitreal bevacizumab (IVB) in DME; they either qualified IVT over IVB or IVB over IVT or did not exhibit a significant difference.

objectiveThis paper aims to compare the efficacy and safety of IVB versus IVT alone or combined IVB+IVT in the treatment of DME.

methodsWe systematically searched PubMed, CENTRAL, Scopus, Embase, Science Direct, OVID, and Web of Science for randomized controlled trials of IVB versus IVT alone or combined IVB+IVT and IVT versus the combined IVB+IVT in DME patients.

resultsA total of 1243 eyes of 17 trials were included in our meta-analysis and regression. Repeated injections of IVB were superior at improving VA comparing with those of IVT at 12, 24, 48-weeks, and IVB+IVT at 12, 24, 48-weeks. Single injections were comparable across the three arms regarding BCVA improvement. CMT reductions were also comparable across the three arms. Meanwhile, the overall safety regarding intraocular pressure and intraocular hypertension significantly favored the IVB group. Improvement in VA was best modified with CMT reduction from 480 um to 320um. This association was significant at 12-weeks in the three arms and persisted till 24-weeks and 48-weeks exclusively in the IVB group. CONCLUSIONS AND RELEVANCE: Our analysis reveals that repeated successive injections associate with better BCVA compared to single injection. Current evidence affirms that IVB is superior to IVT and IVB+IVT at improving BCVA, comparable at reducing CMT, and presents a better safety profile in the treatment of DME.

Indexed as

Angiogenesis InhibitorsBevacizumabDiabetic RetinopathyHumansIntravitreal InjectionsMacular EdemaTreatment OutcomeTriamcinolone AcetonideAngiogenesis InhibitorsBevacizumabTriamcinolone Acetonide

Identifiers

PMID33434220
PMCPMC7802957
OpenAlexW3118804732

What Socratic holds

Textmetadata
LicenceCC BY
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 Socratic graph.