Comparison of Efficacy and Safety between Conbercept and Ranibizumab in Neovascular Age-Related Macular Degeneration: A Meta-Analysis of Randomized Controlled Trials

Abstract

Background: Conbercept, as a novel vascular endothelial growth factor (VEGF) inhibitor, was approved for the treatment of neovascular age-related macular degeneration (nAMD) in China.

Objective: This study aimed to compare the efficacy and safety between conbercept and ranibizumab in patients with nAMD.

Methods: Several databases (PubMed, Web of Science, China National Knowledge Infrastructure, and WANFANG) were searched for the results of studies describing conbercept and ranibizumab for the treatment of nAMD. Sixteen randomized controlled trials including 1,224 eyes met our search criteria and were assessed.

Results: Conbercept and ranibizumab had comparable effects on improving visual acuity at 3 months (standardized mean difference [SMD]: -0.19; 95% confidence interval [CI]: -0.46 to 0.08; p = 0.17) and 6-12 months (SMD: -0.01; 95% CI: -0.20 to 0.18; p = 0.90). At 3 months and 6-12 months, the differences in the change of central macular thickness in conbercept and ranibizumab groups were 1.06 μm (95% CI: -3.52 to 5.64; p = 0.65) and -0.12 μm (95% CI: -9.26 to 9.02; p = 0.98). In the short term, there was no significant difference between the 2 groups with respect to ocular adverse events (odds ratio [OR]: 0.86; 95% CI: 0.46-1.61; p = 0.63). No significant differences were observed in the recovery rate of choroidal neovascularization leakage between conbercept and ranibizumab at both 3 months (OR: 1.49; 95% CI: 0.83-2.68; p = 0.18) and 6-12 months (OR: 0.66; 95% CI: 0.18-2.43; p = 0.53). There were significant differences between conbercept and ranibizumab in terms of decreasing intraocular pressure (weighted mean difference [WMD]: -1.74; 95% CI: -2.28 to -1.20; p < 0.00001), the plasma VEGF level (WMD: -21.49; 95% CI: -26.28 to -16.70; p < 0.00001), and the C-reactive protein level (WMD: -1.16; 95% CI: -1.45 to -0.87; p < 0.00001) in the short term.

Conclusion: Conbercept was similar to ranibizumab in terms of efficacy and safety for the treatment of nAMD in China. Further studies with longer term observation are needed to support this conclusion.

Keywords: Age-related macular degeneration; Conbercept; Meta-analysis; Ranibizumab; Vascular endothelial growth factor.