Conbercept for Treatment of Neovascular Age-Related Macular Degeneration and Visual Impairment due to Diabetic Macular Edema or Pathologic Myopia Choroidal Neovascularization: A Systematic Review and Meta-Analysis

Abstract

Background: Conbercept is a new anti-vascular endothelial growth factor (VEGF) drug. Here, we systematically conducted the efficacy, safety, compliance, and pharmacoeconomic evaluation of intravitreal conbercept (IVC) compared with other treatments in patients with neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), or pathologic myopia choroidal neovascularization (pmCNV).Methods: Databases of PubMed, Embase, Cochrane Library, ClinicalTrials.gov, SinoMed, China National Knowledge Infrastructure, and WanFang Data were systematically searched from the inception to July 27, 2021. Randomized clinical trials and pharmacoeconomic studies comparing IVC with control groups in adults with nAMD, DME, or pmCNV were reviewed and selected. Meta-analyses were performed using the fixed-effects model when pooled data were homogeneous. Heterogeneous data were analyzed using the random-effects model. Primary outcomes included visual improvement rate, mean change in visual acuity or best corrected visual acuity, and pharmacoeconomic outcomes. Additional outcomes were the mean change in fundus examination values, adverse events (AEs), quality-of-life measures, and number of injections.Results: Among 3,591 screened articles, 22 original studies with 1,910 eyes of patients were finally included. For nAMD and DME, IVC was significantly associated with better visual acuity or best corrected visual acuity improvement and fundus quantitative measures than placebo, laser photocoagulation (LP), or intravitreal triamcinolone acetonide (IVT). However, IVC showed non-inferior efficacy to intravitreal ranibizumab (IVR) according to low quality of evidence, and there was lack of trials comparing the priority of IVC to other anti-VEGF regimens. No definitive increased risk of ocular or non-ocular AEs were observed in the study groups. All patients with AEs recovered after symptomatic treatments, and no severe AEs occurred. Patients treated with IVC might have higher quality-of-life scores than those in IVR in nAMD or LP in DME. Additionally, IVC showed cost–utility advantages in nAMD and cost-effectiveness advantages than IVR in pmCNV in China.Conclusion: IVC is well-tolerated and effective for improving vision acuity and quantitative measures in fundus condition in patients with nAMD and DME compared with LP, IVT, and placebo, but gains comparable efficacy to IVR. However, well-designed, large-sample, and long-term evaluation of IVC shall be conducted in additional studies worldwide.

The Anatomic and Functional Outcomes of Ozurdex-Aided Vitrectomy in Proliferative Diabetic Retinopathy

“…Both Ozurdex and Conbercept can effectively treat DME, and both can significantly reduce the CRT of patients. 12 , 13 In terms of pathophysiology, corticosteroids can inhibit the production of pro-inflammatory mediators, reduce VEGF synthesis indirectly, and decrease the loss of endothelial tension-binding proteins. 14 Besides reducing VEGF level, Conbercept treatment also significantly reduced some inflammatory factors, such as intercellular cell adhesion molecule-1 (ICAM-1), macrophage inflammatory protein-1 (MIP-1), IL-1β, IL-6 and TNF-α protein levels in aqueous fluid of PDR patients.…”

Spotlight on iron and ferroptosis: research progress in diabetic retinopathy

“…This therapeutic avenue demonstrates comparable effectiveness to pan-retinal photocoagulation over a span of 5 years ( 124 ). Agents such as ranibizumab, aflibercept, and conbercept play pivotal roles within this framework ( 125 , 126 ). While its therapeutic efficacy is compelling, it exclusively targets one among several risk factors.…”

Novel Approaches in the Drug Development and Delivery Systems for Age-Related Macular Degeneration

“…It is reported to be highly efficacious in controlling neovascularization and retaining vision in 90% of patients [ 69 ]. Aflibercept and conbercept can inhibit placental growth factors as well as VEGF-A, VEGF-B, and VEGF-C, exhibiting multiple targets and more efficacy in the treatment of exudative AMD [ 70 ]. Bispecific antibody-like faricimab inhibits both angiopoietin-2 and VEGF-A, and possesses superior therapeutic action in reducing vascular leaking and inflammatory responses [ 71 ].…”