Bevacizumab in the Treatment of Pterygium: A Meta-Analysis
Bevacizumab in the Treatment of Pterygium: A Meta-Analysis
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DOI：
10.1097/ico.0000000000000037
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发表时间：
2014-02-01
期刊：
影响因子：
2.8
通讯作者：
Ma, Yongping
中科院分区：
文献类型：
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作者：
Hu, Qiongwen;Qiao, Yanbing;Ma, Yongping
目的：本研究旨在评估贝伐珠单抗治疗翼状胬肉的有效性和安全性，主要探讨其对复发率和并发症的影响。方法：我们检索MEDLINE、EMBASE、Web of Science和Cochrane Central Register从建库至2013年7月的相关随机对照试验，探讨贝伐珠单抗治疗翼状胬肉的疗效。提取了有关研究设计、患者特征、治疗和结果的数据。使用 Jadad 评分评估纳入研究的方法学质量。计算复发率和并发症的相对风险（RR）。结果：对9项随机对照试验中总共474例患者482只眼进行了分析。汇总估计结果显示，贝伐珠单抗对预防翼状胬肉复发没有统计学上的显着效果 [RR 0.90，95% 置信区间 (CI) 0.77-1.07，P = 0.23]。亚组分析均未得出支持贝伐珠单抗的显着结果（手术组：RR 0.77，95% CI 0.50-1.18，P = 0.23；非手术组：RR 0.98，95% CI 0.86-1.11，P = 0.76；原发性翼状胬肉组：RR 0.82，95% CI 0.53-1.26，P = 0.36；复发性翼状胬肉组：RR 0.95，95% CI 0.82-1.09，P = 0.44）。 2组间并发症差异无统计学意义（RR=1.00，95%CI=0.73-1.37，P=1.00）。然而，贝伐珠单抗组发生结膜下出血的风险较高（RR 3.34，95% CI 1.07-10.43，P = 0.04）。结论：局部或结膜下贝伐珠单抗相对安全且耐受性良好，但对预防翼状胬肉复发没有统计学意义的效果。需要进行合适剂量的大规模试验和更长时间的随访，以排除任何治疗益处的可能性。
Purpose:The aim of this study was to assess the efficacy and safety of bevacizumab in the treatment of pterygium and to mainly explore its effects on recurrence rate and complications.Methods:We searched MEDLINE, EMBASE, Web of Science, and Cochrane Central Register from the inception to July 2013 for relevant randomized controlled trials that examined bevacizumab therapy for pterygium. Data concerning study design, patient characteristics, treatment, and outcomes were extracted. The methodological quality of the studies included was assessed using the Jadad score. Relative risk (RR) was calculated for recurrence rate and complications.Results:A total of 474 patients with 482 eyes in 9 randomized controlled trials were analyzed. The pooled estimate showed that bevacizumab had no statistically significant effect on preventing pterygium recurrence [RR 0.90, 95% confidence interval (CI) 0.77-1.07, P = 0.23]. None of the subgroup analyses yielded significant results in favor of bevacizumab (surgery group: RR 0.77, 95% CI 0.50-1.18, P = 0.23; nonsurgery group: RR 0.98, 95% CI 0.86-1.11, P = 0.76; primary pterygium group: RR 0.82, 95% CI 0.53-1.26, P = 0.36; recurrent pterygium group: RR 0.95, 95% CI 0.82-1.09, P = 0.44). There were no statistically significant differences in the complications between the 2 groups (RR 1.00, 95% CI 0.73-1.37, P = 1.00). However, the bevacizumab group was associated with a higher risk of developing subconjunctival hemorrhage (RR 3.34, 95% CI 1.07-10.43, P = 0.04).Conclusions:Topical or subconjunctival bevacizumab was relatively safe and well tolerated, but it had no statistically significant effect on preventing pterygium recurrence. A large-scale trial with a suitable dosage and a longer follow-up would be required to rule out the possibility of any treatment benefit.