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Treats neovascular (wet) age-related macular degeneration (AMD) and macular edema after retinal vein occlusion.

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Results: 17

Age-related macular degeneration: What are the advantages or disadvantages of aflibercept (Eylea)?

The drug aflibercept (trade name: Eylea) was approved in Germany in November 2012 for the treatment of neovascular (wet) age-related macular degeneration (AMD) in adults. Due to a lack of suitable data, it is not clear whether it has advantages or disadvantages compared with the current standard therapy.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: July 18, 2013

Risk of gastrointestinal perforation in cancer patients treated with aflibercept: a systematic review and meta-analysis

Gastrointestinal (GI) perforation is a serious adverse event associated with aflibercept, a novel vascular endothelial growth factor (VEGF)-targeted agent currently approved as second-line treatment for previously treated metastatic colorectal cancer, but the incidence and risk of GI perforation associated with aflibercept has not been well determined. We thus conducted this meta-analysis to investigate the overall incidence and risk of developing GI perforation associated with aflibercept. Databases from PubMed, Web of Science, and abstracts presented at American Society of Clinical Oncology (ASCO) and European Society of Medical Oncology (ESMO) meeting up to January, 2014 were searched to identify relevant studies. Eligible studies included prospective phase II and III trials evaluating aflibercept in cancer patients with adequate data on GI perforation. Statistical analyses were conducted to calculate the summary incidence, odds ratio, and 95 % confidence intervals (CIs) by using either random effects or fixed effect models according to the heterogeneity of included studies. A total of 4,101 patients with a variety of solid tumors from eight clinical trials were included in our analysis. The incidence of GI perforation associated with aflibercept was 1.9 % (95 %CI, 1.0-3.8 %), with a mortality of 10.8 % (95%CI, 4.1-25.5 %). In addition, patients treated with aflibercept had a significantly increased risk of developing all-grade (OR 3.76; 95%CI, 1.94-7.25; p < 0.001) and high-grade GI (OR 4.14; 95 %CI; 2.12-8.06; p < 0.001) perforation compared with patients treated with control medication. No evidence of publication bias was observed. The use of aflibercept is associated with a significantly increased risk of GI perforation compared to controls.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Treatment-related mortality with aflibercept in cancer patients: a meta-analysis

PURPOSE: Aflibercept, a fully humanized vascular endothelial growth factor (VEGF)-targeted agent, has emerged as an effective therapy in the treatment of various solid tumors. We carried out an up-to-date meta-analysis to determine the risk of fatal adverse events (FAEs) in cancer patients treated with aflibercept.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Risk of hypertension in cancer patients treated with aflibercept: a systematic review and meta-analysis

BACKGROUND: Aflibercept is currently approved as second-line treatment for patients with metastatic colorectal cancer, and its application in other types of tumors is undergoing clinical evaluation. Hypertension is one of its major adverse effects with a substantial variation in the reported incidences and has not been systematically investigated.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Hemorrhagic events in cancer patients treated with aflibercept: a meta-analysis

Aflibercept (Ziv-aflibercept, VEGF Trap, AVE005) is an engineered protein that functions as a decoy receptor to bind vascular endothelial growth factor A (VEGF-A). Hemorrhagic events, including epistaxis, gastrointestinal bleeding, and pulmonary bleeding, is one of its major adverse effects, but the incidence rate and overall risk has not been systematically studied. Therefore, we conducted a meta-analysis of published clinical trials to investigate the incidence and relative risk of hemorrhagic events in cancer patients treated with aflibercept. Electronic databases including PubMed, Embase, Cochrane databases, and American Society of Clinical Oncology abstracts were searched. Eligible studies were phase II and III prospective clinical trials of cancer patients treated with aflibercept with toxicity profile on hemorrhagic events. Overall incidence rates, relative risk (RR), and 95 % confidence intervals (CI) were calculated using fixed or random effects models depending on the heterogeneity of the included studies. A total of 4,538 patients with a variety of solid tumors from 13 prospective clinical trials were included for the meta-analysis. The overall incidences of all-grade and high-grade hemorrhagic events in cancer patients were 22.1 % (95 % CI, 16.5-29.7 %) and 4.2 % (95 % CI, 3.9-4.6 %), respectively. The relative risks of hemorrhagic events of aflibercept compared to control were increased for all-grade (RR = 2.63; 95 % CI, 2.07-3.34) and high-grade (RR = 2.45, 95 % CI, 1.62-3.72) hemorrhagic events. The risk of developing high-grade hemorrhagic events with aflibercept was comparable to that of bevacizumab (RR = 1.26; 95 % CI, 0.89-1.79). Aflibercept is associated with an increased risk of developing hemorrhagic events in patients with solid tumors. Close monitoring and management of hemorrhagic events are recommended.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Drug treatment of macular oedema secondary to central retinal vein occlusion: a network meta-analysis

OBJECTIVE: To indirectly compare aflibercept, bevacizumab, dexamethasone, ranibizumab and triamcinolone for treatment of macular oedema secondary to central retinal vein occlusion using a network meta-analysis (NMA).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Efficacy of anti-VEGF and laser photocoagulation in the treatment of visual impairment due to diabetic macular edema: a systematic review and network meta-analysis

OBJECTIVE: Compare the efficacy of ranibizumab, aflibercept, laser, and sham in the first-line treatment of diabetic macular edema (DME) to inform technology assessments such as those conducted by the UK National Institute for Health and Care Excellence (NICE).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Treatments for macular oedema following central retinal vein occlusion: systematic review

OBJECTIVES: To review systematically the randomised controlled trial (RCT) evidence for treatment of macular oedema due to central retinal vein occlusion (CRVO).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Comparative effectiveness of anti-VEGF agents for diabetic macular edema

OBJECTIVES: The aim of this study was to evaluate the comparative effectiveness of anti-vascular endothelial growth factor therapy in the treatment of diabetic macular edema (DME).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Efficacy and safety of intravitreal therapy in macular edema due to branch and central retinal vein occlusion: a systematic review

BACKGROUND: Intravitreal agents have replaced observation in macular edema in central (CRVO) and grid laser photocoagulation in branch retinal vein occlusion (BRVO). We conducted a systematic review to evaluate efficacy and safety outcomes of intravitreal therapies for macular edema in CRVO and BRVO.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

A meta-analysis of anti-vascular endothelial growth factor remedy for macular edema secondary to central retinal vein occlusion

BACKGROUND: Central retinal vein occlusion (CRVO) associates with severe vision outcome and no proven beneficial treatment. Our meta-analysis intended to appraise the efficacy and safety of anti-vascular endothelial growth factor (anti-VEGF) agents in macular edema (ME) following CRVO.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Current treatments in diabetic macular oedema: systematic review and meta-analysis

The authors concluded that, in patients with diabetic macular oedema, anti-VEGFs (ranibizumab and bevacizumab) consistently showed good clinical effectiveness without major adverse effects. Results for steroids were mixed and associated with cataracts and intraocular pressure increase. Concerns about study (reporting) quality and the relatively limited synthesis means that the conclusions should not be seen as definitive.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Anti‐vascular endothelial growth factor for diabetic macular oedema

Diabetic macular oedema (DMO) is a common complication of diabetic retinopathy. The retina at the macula thickens and this can cause gradual loss of central vision. Grid or focal laser photocoagulation is effective in treating DMO and has been used for several years, but vision is rarely improved.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Anti‐vascular endothelial growth factor for macular oedema secondary to central retinal vein occlusion

We reviewed the evidence about the effect of anti‐vascular endothelial growth factor (anti‐VEGF) agents in people with macular oedema secondary to central retinal vein occlusion (CRVO).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Colon Cancer Treatment (PDQ®): Health Professional Version

Expert-reviewed information summary about the treatment of colon cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 5, 2014

A Systematic Review of Intravitreal Bevacizumab for the Treatment of Diabetic Macular Edema [Internet]

Diabetic retinopathy (DR) and diabetic macular edema (DME) are microvascular complications of diabetes that are a leading cause of blindness in the diabetic population. DME — which is swelling of the retina due to leakage of fluid from blood vessels within the macula, the central portion of the retina — may occur at any time during the progression of DR. The goal of treatment is to preserve current visual acuity and reduce the chances of progression to visual loss. Successful laser treatment reduces moderate visual loss but has limited effects on improving visual acuity. Intravitreal injection of corticosteroids, such as triamcinolone acetate, may also moderately improve visual acuity, but these generally offer only short-term improvements in acuity in cases of DME refractory to laser treatment. Moreover, triamcinolone is not licensed by Health Canada for this indication. Ranibizumab is a recombinant humanized monoclonal immunoglobulin G1 antibody that binds to and inhibits the biologic activity of human vascular endothelial growth factor (VEGF). It is the only pharmacological therapy licensed in Canada for the treatment of DME.

Rapid Response Report: Peer-Reviewed Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: May 2012
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Colorectal Cancer: The Diagnosis and Management of Colorectal Cancer

This guideline is relevant to all healthcare professionals who come into contact with patients with colorectal cancer or suspected of having colorectal cancer, as well as to the patients themselves and their carers. It is also expected that the guideline will be of value to those involved in clinical governance in both primary and secondary care to help ensure that arrangements are in place to deliver appropriate care for the population covered by this guideline.

NICE Clinical Guidelines - National Collaborating Centre for Cancer (UK).

Version: November 2011
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