01.12.2018 | Research article | Ausgabe 1/2018 Open Access

An efficacy comparison of anti-vascular growth factor agents and laser photocoagulation in diabetic macular edema: a network meta-analysis incorporating individual patient-level data
- Zeitschrift:
- BMC Ophthalmology > Ausgabe 1/2018
Electronic supplementary material
Background
Methods
Search strategy
Inclusion criteria
Data extraction
Analyses
Results
Networks
IPD and aggregate network | IPD-only network |
---|---|
DRCR.net Protocol I | DRCR.net Protocol I |
DRCR.net Protocol J | DRCR.net Protocol J |
DRCR.net Protocol T | VISTA-DME |
LUCIDATEa | VIVID-DME |
RESPONDb | VIVID-EAST |
RESTORE | |
RETAIN | |
REVEAL | |
RIDEa | |
RISEa | |
VISTA-DME | |
VIVID-DME | |
VIVID-EAST |
Mean change in BCVA (continuous outcome)
IPD-only network | IPD and aggregate network | |||||
---|---|---|---|---|---|---|
Comparison | Covariable adjustment | Model | Mean difference | 95% Crl | Mean difference | 95% Crl |
IVT-AFL 2q8 vs laser | None | Fixed | + 10.32a | 8.31–12.34 | + 10.32a | 8.30–12.35 |
Random | + 10.47a | 6.92–14.16 | + 10.45a | 7.81–13.12 | ||
Common (baseline BCVA) | Fixed | + 10.30a | 8.82–11.78 | + 10.27a | 8.79–11.74 | |
Random | + 10.54a | 7.07–14.42 | + 10.47a | 7.88–13.11 | ||
Treatment-specific | Fixed | + 10.48a | 8.99–11.97 | – | – | |
Random | + 10.65a | 7.13–14.34 | ||||
IVT-AFL 2q8 vs ranibizumab 0.5 mg PRN | None | Fixed | + 3.92a | 0.60–7.24 | + 4.42a | 2.07–6.76 |
Random | + 3.47 | −3.14–10.44 | + 5.15a | 1.82–8.54 | ||
Common (baseline BCVA) | Fixed | + 3.14a | 0.48–5.80 | + 4.95a | 3.09–6.83 | |
Random | + 3.54 | −2.93–10.81 | + 5.20a | 1.90–8.52 | ||
Treatment-specific | Fixed | + 3.09a | 0.44–5.72 | – | – | |
Random | + 3.38 | −3.20–10.18 | ||||
IVT-AFL 2q8 vs ranibizumab 0.5 mg PRN + laser | None | Fixed | + 5.96a | 2.65–9.25 | + 5.17a | 2.73–7.61 |
Random | + 6.05a | 0.45–12.19 | + 5.95a | 2.60–9.37 | ||
Common (baseline BCVA) | Fixed | + 5.71a | 3.11–8.29 | + 5.77a | 3.81–7.74 | |
Random | + 6.16a | 0.67–12.55 | + 6.00a | 2.66–9.36 | ||
Treatment-specific | Fixed | + 5.68a | 3.06–8.29 | – | – | |
Random | + 6.03a | 0.51–11.94 | ||||
IVT-AFL 2q8 vs ranibizumab 0.5 mg T&E | None | Fixed | – | – | + 5.06a | 1.88–8.23 |
Random | + 5.07 | −0.37–10.54 | ||||
Common (baseline BCVA) | Fixed | – | – | + 4.90a | 2.06–7.72 | |
Random | + 5.15 | −0.26–10.61 | ||||
Treatment-specific | Fixed | – | – | – | – | |
Random | ||||||
IVT-AFL 2q8 vs ranibizumab 0.5 mg T&E + laser | None | Fixed | – | – | + 5.07a | 2.00–8.13 |
Random | + 3.80 | − 1.57–9.25 | ||||
Common (baseline BCVA) | Fixed | – | – | + 3.65a | 0.94–6.35 | |
Random | + 3.90 | −1.42–9.25 | ||||
Treatment-specific | Fixed | – | – | – | – | |
Random |
Proportion of patients gaining or losing ≥10 and ≥ 15 ETDRS letters (binary outcomes)
Gain ≥10 ETDRS letters | Gain ≥15 ETDRS letters | |||||
---|---|---|---|---|---|---|
IPD-only network Comparison | Covariable adjustment | Model | OR | 95% Crl | OR | 95% Crl |
IVT-AFL 2q8 vs laser | None | Fixed | 4.82a | 3.52–6.46 | 4.97a | 3.32–7.26 |
Random | 18.72a | 1.16–20.20 | 5.76a | 1.97–12.24 | ||
Common (baseline BCVA) | Fixed | 4.96a | 3.57–6.73 | 5.49a | 3.47–8.38 | |
Random | 60.90a | 1.06–26.91 | 7.58a | 1.79–15.34 | ||
Treatment-specific | Fixed | 5.10a | 3.67–6.94 | 5.64a | 3.55–8.66 | |
Random | 7.28a | 1.16–24.20 | 534.90a | 1.85–19.79 | ||
IVT-AFL 2q8 vs ranibizumab 0.5 mg PRN | None | Fixed | 2.10a | 1.19–3.45 | 2.59a | 1.29–4.69 |
Random | 93,680.00 | 0.10–29.60 | 10.68 | 0.53–14.63 | ||
Common (baseline BCVA) | Fixed | 2.09a | 1.15–3.48 | 2.85a | 1.35–5.35 | |
Random | 32.25 | 0.08–42.16 | 59.97 | 0.37–20.4 | ||
Treatment-specific | Fixed | 1.99a | 1.07–3.38 | 3.06a | 1.43–5.85 | |
Random | 594.80 | 0.14–43.29 | 2056.00 | 0.43–39.48 | ||
IVT-AFL 2q8 vs ranibizumab 0.5 mg PRN + laser | None | Fixed | 3.04a | 1.82–4.77 | 2.74a | 1.44–4.78 |
Random | 22.24 | 0.29–31.29 | 5.93 | 0.76–13.29 | ||
Common (baseline BCVA) | Fixed | 2.92a | 1.70–4.68 | 2.88a | 1.44–5.23 | |
Random | 969.00 | 0.28–41.36 | 10.13 | 0.59–16.11 | ||
Treatment-specific | Fixed | 2.99a | 1.73–4.81 | 2.99a | 1.48–5.44 | |
Random | 22.32 | 0.37–47.51 | 52.20 | 0.60–23.38 | ||
Gain ≥10 ETDRS letters | Gain ≥15 ETDRS letters | |||||
IPD and aggregate network Comparison | Covariable adjustment | Model | OR | 95% Crl | OR | 95% Crl |
IVT-AFL 2q8 vs laser | None | Fixed | 4.82a | 3.52–6.45 | 4.97a | 3.32–7.28 |
Random | 5.06a | 2.39–9.49 | 5.03a | 3.09–7.88 | ||
Common (baseline BCVA) | Fixed | 4.93a | 3.55–6.72 | 5.58a | 3.52–8.58 | |
Random | 5.27a | 2.44–9.91 | 5.62a | 3.28–9.15 | ||
IVT-AFL 2q8 vs ranibizumab 0.5 mg PRN | None | Fixed | 1.72a | 1.11–2.53 | 2.07a | 1.19–3.38 |
Random | 1.76 | 0.62–3.94 | 2.08a | 1.06–3.70 | ||
Common (baseline BCVA) | Fixed | 1.71a | 1.09–2.56 | 2.28a | 1.25–3.85 | |
Random | 1.79 | 0.63–4.06 | 2.30a | 1.12–4.20 | ||
IVT-AFL 2q8 vs ranibizumab 0.5 mg PRN + laser | None | Fixed | 2.01a | 1.32–2.94 | 2.11a | 1.22–3.42 |
Random | 2.18 | 0.81–4.78 | 2.14a | 1.12–3.76 | ||
Common (baseline BCVA) | Fixed | 1.96a | 1.26–2.92 | 2.27a | 1.26–3.83 | |
Random | 2.20 | 0.81–4.90 | 2.31a | 1.15–4.20 | ||
IVT-AFL 2q8 vs ranibizumab 0.5 mg T&E | None | Fixed | 1.57 | 0.76–2.86 | 1.78 | 0.76–3.55 |
Random | 1.88 | 0.30–6.26 | 1.86 | 0.63–4.18 | ||
Common (baseline BCVA) | Fixed | 1.55 | 0.75–2.85 | 1.96 | 0.81–4.00 | |
Random | 1.95 | 0.32–6.47 | 2.04 | 0.67–4.77 | ||
IVT-AFL 2q8 vs ranibizumab 0.5 mg T&E + laser | None | Fixed | 2.41a | 1.15–4.48 | 3.22a | 1.32–6.68 |
Random | 2.88 | 0.47–9.68 | 3.35a | 1.09–7.84 | ||
Common (baseline BCVA) | Fixed | 2.39a | 1.13–4.48 | 3.56a | 1.42–7.53 | |
Random | 3.02 | 0.48–9.87 | 3.73a | 1.16–8.88 |
Loss ≥10 ETDRS letters | Loss ≥15 ETDRS letters | |||||
---|---|---|---|---|---|---|
IPD-only network Comparison | Covariable adjustment | Model | OR | 95% Crl | OR | 95% Crl |
IVT-AFL vs laser | None | Fixed | 0.06a | 0.02–0.12 | 0.04a | 0.01–0.112 |
Random | 0.11a | 0.01–0.29 | 0.22a | 0.00–0.28 | ||
Common (baseline BCVA) | Fixed | 0.06a | 0.02–0.12 | 0.04a | 0.00–0.11 | |
Random | 0.19a | 0.01–0.27 | 0.07a | 0.00–0.24 | ||
Treatment-specific | Fixed | 0.05a | 0.02–0.11 | 0.02a | 0.00–0.08 | |
Random | 0.08a | 0.01–0.24 | 0.04a | 0.00–0.16 | ||
IVT-AFL vs ranibizumab 0.5 mg PRN | None | Fixed | 0.37 | 0.07–1.22 | 0.51 | 0.02–2.51 |
Random | 92.49 | 0.01–8.70 | 278,400.00 | 0.00–39.31 | ||
Common (baseline BCVA) | Fixed | 0.37 | 0.07–1.24 | 0.47 | 0.02–2.34 | |
Random | 483.00 | 0.01–6.20 | 825.00 | 0.00–22.22 | ||
Treatment-specific | Fixed | 0.51 | 0.07–2.07 | 0.45 | 0.00–2.59 | |
Random | 9.28 | 0.01–7.53 | 300.00 | 0.00–15.68 | ||
IVT-AFL vs ranibizumab 0.5 mg PRN + laser | None | Fixed | 0.17a | 0.04–0.44 | 0.23a | 0.02–0.91 |
Random | 6.74 | 0.01–2.11 | 74.93 | 0.00–7.32 | ||
Common (baseline BCVA) | Fixed | 0.18a | 0.04–0.47 | 0.20a | 0.02–0.81 | |
Random | 12.89 | 0.01–1.75 | 11.07 | 0.00–5.17 | ||
Treatment-specific | Fixed | 0.18a | 0.04–0.51 | 0.13a | 0.00–0.65 | |
Random | 3.38 | 0.01–1.89 | 5.42 | 0.00–3.04 | ||
Loss ≥10 ETDRS letters | Loss ≥15 ETDRS letters | |||||
IPD and aggregate network Comparison | Covariable adjustment | Model | OR | 95% Crl | OR | 95% Crl |
IVT-AFL 2q8 vs laser | None | Fixed | 0.06a | 0.02–0.12 | 0.04a | 0.00–0.12 |
Random | 0.06a | 0.02–0.14 | 0.04a | 0.00–0.14 | ||
Common (baseline BCVA) | Fixed | 0.06a | 0.02–0.12 | 0.04a | 0.00–0.11 | |
Random | 0.06a | 0.02–0.14 | 0.04a | 0.00–0.13 | ||
IVT-AFL 2q8 vs ranibizumab 0.5 mg PRN | None | Fixed | 0.24a | 0.07–0.60 | 0.31 | 0.02–1.15 |
Random | 0.25a | 0.05–0.73 | 0.36 | 0.02–1.49 | ||
Common (baseline BCVA) | Fixed | 0.24a | 0.07–0.59 | 0.28 | 0.02–1.05 | |
Random | 0.25a | 0.05–0.74 | 0.33 | 0.02–1.39 | ||
IVT-AFL 2q8 vs ranibizumab 0.5 mg PRN + laser | None | Fixed | 0.14a | 0.04–0.33 | 0.11a | 0.01–0.37 |
Random | 0.15a | 0.03–0.41 | 0.13a | 0.01–0.47 | ||
Common (baseline BCVA) | Fixed | 0.14a | 0.04–0.33 | 0.10a | 0.01–0.34 | |
Random | 0.15a | 0.03–0.41 | 0.11a | 0.01–0.43 | ||
IVT-AFL 2q8 vs ranibizumab 0.5 mg T&E | None | Fixed | 0.15a | 0.01–0.75 | 0.33 | 0.00–1.94 |
Random | 0.19a | 0.00–0.96 | 0.81 | 0.00–3.00 | ||
Common (baseline BCVA) | Fixed | 0.15a | 0.00–0.73 | 0.30 | 0.00–1.74 | |
Random | 0.21a | 0.00–0.97 | 0.54 | 0.00–2.67 | ||
IVT-AFL 2q8 vs ranibizumab 0.5 mg T&E + laser | None | Fixed | 222,500.00 | 0.03–607.2 | 201,200.00 | 0.02–671.3 |
Random | 325,000.00 | 0.02–589.9 | 130,000.00 | 0.01–751.0 | ||
Common (baseline BCVA) | Fixed | 470,400.00 | 0.03–555.1 | 3,311,000.00 | 0.02–592.0 | |
Random | 662,700.00 | 0.02–622.8 | 2,877,000.00 | 0.01–775.5 |