Evidence mapPaperPMID 37198521Full record

ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2023

Efficacy and Safety of Brolucizumab, Aflibercept, and Ranibizumab for the Treatment of Patients with Visual Impairment Due to Diabetic Macular Oedema: A Systematic Review and Network Meta-Analysis.

Shelby Sydnor, Swarnendu Chatterjee, Philip Cooney, Simarjeet Kaur, Tom Macmillan, Daisy Stewart, Isobel Munro, Cátia Bandeiras, Abby Paine, Federico Felizzi

Open access · goldAbstract read
In one paragraph

Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.4field-weighted citation impact, top 20% 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

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. 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

10 authors at 5 institutions in 4 countries.

Shelby SydnorNovartis Pharmaceuticals UK Ltd., London, England, UK.
Swarnendu ChatterjeeCONEXTS, Novartis Healthcare Pvt. Ltd., Hyderabad, India.
Philip CooneyCONEXTS, Novartis Ireland Ltd., Dublin, Ireland.
Simarjeet KaurCONEXTS, Novartis Healthcare Pvt. Ltd., Hyderabad, India.
Tom MacmillanSource Health Economics, Oxford, England, UK.ORCID http://orcid.org/0000-0001-7274-797X
Daisy StewartSource Health Economics, Oxford, England, UK.
Isobel MunroSource Health Economics, London, England, UK.ORCID http://orcid.org/0000-0002-2456-3591
Cátia BandeirasCONEXTS, Novartis Ireland Ltd., Dublin, Ireland.ORCID http://orcid.org/0000-0001-6959-3746
Abby PaineSource Health Economics, Oxford, England, UK.ORCID http://orcid.org/0000-0002-2332-1099
Federico FelizziNovartis Pharma AG, Fabrikstrasse 2, 4056, Basel, Switzerland. federico.felizzi@novartis.com.
Novartis (India) · INNovartis (Ireland) · IENovartis (Switzerland) · CHNovartis (United Kingdom) · GBOffice Of Health Economics · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionKey clinical guidelines recommend anti-vascular endothelial growth factor (VEGF) therapy as first-line treatment for visual impairment due to diabetic macular oedema (DMO). A systematic literature review (SLR) and network meta-analysis (NMA) were conducted comparing the relative efficacy of the anti-VEGF brolucizumab with a focused network of the most relevant comparator dosing regimens approved in countries other than the USA (aflibercept, ranibizumab). The safety and tolerability of brolucizumab were also assessed.

methodsA broad SLR was conducted to identify randomised controlled trials to ensure all relevant potential comparators were captured. Identified studies were refined to those appropriate for inclusion in the NMA. A Bayesian NMA was conducted comparing brolucizumab 6 mg (every 12 [Q12W]/every 8 weeks [Q8W]) with relevant aflibercept 2 mg and ranibizumab 0.5 mg regimens.

resultsFourteen studies were included in the NMA. At 1-year follow-up, the various aflibercept 2 mg and ranibizumab 0.5 mg regimens were mostly comparable with brolucizumab 6 mg Q12W/Q8W across key visual and anatomical outcomes, except brolucizumab 6 mg was favoured over ranibizumab 0.5 mg every 4 weeks (Q4W) for the change from baseline (CFB) in best-corrected visual acuity (BCVA), and BCVA loss/gain of pre-specified numbers of letters, and over ranibizumab 0.5 mg pro re nata for CFB in diabetic retinopathy severity scale, and retinal thickness. At year 2, where data were available, brolucizumab 6 mg showed similar results across efficacy outcomes versus all other anti-VEGFs. In most cases, discontinuation rates (all cause, and due to adverse events [AE]) and serious and overall rates of AEs excluding ocular inflammatory events were similar (in unpooled and pooled-treatment analyses) versus comparators.

conclusionBrolucizumab 6 mg Q12W/Q8W was comparable or superior to aflibercept 2 mg and ranibizumab 0.5 mg regimens for various visual and anatomical efficacy outcomes and discontinuation rates.

Indexed as

AfliberceptAnti-VEGFBest-corrected visual acuityBrolucizumabDiabetic macular oedemaDiabetic retinopathyNetwork meta-analysisRanibizumabRetinal thicknessVisual impairment

Identifiers

PMID37198521
PMCPMC10241757
OpenAlexW4376958928

What Socratic holds

Textmetadata
LicenceCC BY-NC
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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.