Summary

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• This summary is based on the review of 37 systematic review(s)/meta-analysis(es). ^[1-37]
• Faricimab demonstrated comparable efficacy to other anti-vascular endothelial growth factor (VEGF) agents (aflibercept, ranibizumab, bevacizumab) in visual acuity improvement and was superior in reducing post-treatment retinal fluid compared to aflibercept (every 8 weeks), ranibizumab, and bevacizumab. It also reduced the number of annual injections compared to most fixed and flexible anti-VEGF regimens.
• Brolucizumab showed higher efficacy in visual acuity improvement compared to aflibercept and ranibizumab and was effective in reducing intraretinal fluid (IRF) and subretinal fluid (SRF).
• Aflibercept exhibited comparable visual acuity efficacy to ranibizumab in central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO), and moderate superiority over bevacizumab and conbercept in diabetic macular edema (DMO). It was effective in reducing central subfield thickness.
• Faricimab: Safety profile comparable to other anti-VEGF agents, with fewer serious ocular adverse events compared to brolucizumab.
• Brolucizumab: Higher incidence of serious ocular adverse events compared to aflibercept and ranibizumab, while overall adverse events are similar to other anti-VEGF agents.
• Aflibercept and Ranibizumab: Comparable safety profiles, including both ocular and non-ocular adverse events, with no significant increase in all-cause mortality for aflibercept.
• The evidence source provides information on specific population types or subgroups such as neovascular age-related macular degeneration (nAMD), DMO, and retinal vein occlusion (RVO). In nAMD, faricimab showed efficacy in visual acuity and reduced injection frequency in a naive population, while brolucizumab was effective in improving visual acuity and reducing retinal fluid. In DMO, aflibercept was slightly more effective than ranibizumab and bevacizumab in improving vision. In RVO, aflibercept and ranibizumab had comparable efficacy. Limited data is available for pregnant and breastfeeding women regarding anti-VEGF agents, with no clear association with compromised obstetric outcomes.