Evidence map›Paper›PMID 39676768›Full record

ArticleClinical ophthalmology (Auckland, N.Z.)2024

Brolucizumab versus Aflibercept in Patients with Diabetic Macular Edema: A Meta-Analysis of Randomized Controlled Trials.

Leonardo B Justino, Gustavo B Justino, Fabrissio P Graffunder, William W Binotti, Ali Khodor, Jonathan T Caranfa

Abstract read
In one paragraph

Article in Clinical ophthalmology (Auckland, N.Z.), 2024. 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
–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

3 citing papers in PubMed.

  1. Review
  2. Review
  3. 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

6 authors.

Leonardo B JustinoDivision of Medicine, Federal University of Santa Catarina, Florianópolis, SC, Brazil.ORCID 0000-0002-6267-3214
Gustavo B JustinoDivision of Medicine, Federal University of Santa Catarina, Florianópolis, SC, Brazil.
Fabrissio P GraffunderDivision of Ophthalmology, Governador Celso Ramos Hospital, Florianópolis, SC, Brazil.ORCID 0000-0002-0224-846X
William W BinottiTufts Medical Center, New England Eye Center, Boston, MA, USA.
Ali KhodorBascom Palmer Eye Institute, University of Miami, Miami, FL, USA.ORCID 0009-0004-8752-919X
Jonathan T CaranfaTufts Medical Center, New England Eye Center, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: To assess efficacy and safety of brolucizumab versus aflibercept in patients with diabetic macular edema (DME). Patients and Methods: We performed a systematic review and meta-analysis with trial sequential analysis (TSA). We searched Embase, Cochrane Central Register of Controlled Trials and PubMed databases from inception to February 16, 2024 for randomized controlled trials (RCTs) comparing brolucizumab with aflibercept in patients with DME and reporting any of the visual, anatomical and safety outcomes of interest. We conducted a TSA of safety outcomes to assess the risk of statistical errors. Results: 1253 patients (1253 eyes) from 3 RCTs were included, of whom 57% received brolucizumab and 43% received aflibercept. Mean follow-up ranged from 52 to 100 weeks. Brolucizumab was non-inferior to aflibercept when comparing the mean change of best-corrected visual acuity from baseline (least squares mean difference [LSMD] 0.29; 95% confidence interval [CI] -1.37 to 1.95; p = 0.73). Change in central subfield thickness was significantly greater in the brolucizumab group compared with aflibercept (LSMD -24.5 μm; 95% CI -48.2 to -0.7 μm; p < 0.05). Incidence of adverse events of special interest (AESIs) (risk ratio [RR] 1.7; p = 0.08) and incidence of ≥1 ocular adverse events (AEs) (RR 0.95; p = 0.45) were not significantly different between groups. Conclusion: Brolucizumab was non-inferior in functional outcomes and was superior to aflibercept in anatomical parameters. Ocular AEs and AESIs were numerically low and not statistically significant. Our findings underscore the importance of new RCTs powered to assess safety outcomes in order to suggest brolucizumab as an alternative to the treatment of DME.

Indexed as

afliberceptanti-VEGFbrolucizumabdiabetic macular edemadiabetic retinopathy

Identifiers

PMID39676768
PMCPMC11645907

What Socratic 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 Socratic graph.