Ranibizumab injection for diabetic macular edema: meta-analysis of systemic safety and systematic review.
OBJECTIVE
To conduct a systematic review on the safety of ranibizumab injections for diabetic macular edema by meta-analysis of recently conducted level 1 randomized clinical trials.


METHODS
A meta-analysis and systematic review.


METHODS
Main outcome measures of permissible studies were extracted and reported. The relative risk (RR) for thromboembolic events (TEEs) was calculated for those studies that met this study's inclusion criteria. The fixed-effects model (Mantel-Haenszel method) was appropriately used to calculate the pooled RR. The quality of trials was assessed using the Jadad score.


RESULTS
Of the 2072 patients who were included from 5 [corrected] eligible randomized clinical trials, 1295 patients received intravitreal ranibizumab injections. The pooled RR for TEEs after ranibizumab intravitreal injection was 0.74 (95% CI 0.52-1.06).


CONCLUSIONS
Intravitreal ranibizumab for the treatment of diabetic macular edema did not increase the risk for TEEs as shown by this meta-analysis of 4 randomized, controlled clinical trials.
King Saud University, Riyadh, Saudi Arabia. dr.abouammoh@gmail.com
Marwan A
MA
Abouammoh
D020533:Angiogenesis Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D003930:Diabetic Retinopathy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D000069579:Ranibizumab; D018570:Risk Assessment; D013923:Thromboembolism / Q000139:chemically induced; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab