Effect of Intravitreal Anti-Vascular Endothelial Growth Factor Therapy on the Risk of Arterial Thromboembolic Events A Meta-Analysis 英文参考文献.docVIP
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Effect of Intravitreal Anti-Vascular Endothelial Growth Factor Therapy on the Risk of Arterial Thromboembolic Events A Meta-Analysis 英文参考文献
EffectofIntravitrealAnti-VascularEndothelialGrowth
FactorTherapyontheRiskofArterialThromboembolic
Events:AMeta-Analysis
Jin-WeiCheng1.,Shi-WeiCheng2.,Guo-CaiLu3*,Rui-LiWei1*
1Department of Ophthalmology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China, 2School of Life Sciences, Ludong University,
Yantai,China,3CenterforNewDrugEvaluation,InstituteofBasicMedicalScience,SecondMilitaryMedicalUniversity,Shanghai,China
Abstract
Background: Intravitreal anti-vascular endothelial growth factor (VEGF) monoclonal antibodies are used in ocular
neovasculardiseases.Aconsensushasemergedthatintravenousanti-VEGFcanincreasetheriskofarterialthromboembolic
events. However, the role of intravitreal anti-VEGF in arterial thromboembolism is controversial. Therefore, we did
a systematic review and meta-analysis to investigate the effects of intravitreal anti-VEGF on the risk of arterial
thromboembolicevents.
Methods:Electronicdatabasesweresearchedtoidentifyrelevantrandomizedclinicaltrialscomparingintravitrealanti-VEGF
withcontrols.Criteriaforinclusioninourmeta-analysisincludedastudydurationofnolessthan12months,theuseof
a randomized control group not receiving any intravitreal active agent, and the availability of outcome data for arterial
thromboembolicevents,myocardialinfarction,cerebrovascularaccidents,andvasculardeath.Theriskratiosand95%CIs
werecalculatedusingafixed-effectsorrandom-effectsmodel,dependingontheheterogeneityoftheincludedstudies.
Results:Atotalof4942patientswithavarietyofocularneovasculardiseasesfrom13randomizedcontrolledtrialswere
identifiedandincludedforanalysis.Therewasnosignificantdifferencebetweenintravitrealanti-VEGFandcontrolintherisk
ofallevents,withriskratiosof0.87(95%CI,0.64to1.19)forarterialthromboembolicevents,0.96(95%CI,0.55–1.68)for
cerebrovascularaccidents,0.69(95%CI0.40–1.21)formyocardialinfarctions,and0.68(95%CI,0.37–1.27)forvasculardeath.
Conclusions: The strength evidence suggests that the intravitreal use of anti-VEG
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