Summary

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• This summary is based on the review of 44 systematic review(s)/meta-analysis(es). ^[1-43]
• Faricimab demonstrated comparable Early Treatment of Diabetic Retinopathy Study (ETDRS) letter gain outcomes to aflibercept, ranibizumab, and bevacizumab in both fixed and pro re nata (PRN) schedules. Brolucizumab showed superior best-corrected visual acuity (BCVA) improvement over aflibercept and ranibizumab in intraretinal fluid (IRF) and/or subretinal fluid (SRF) presence and serious adverse events. Aflibercept achieved similar BCVA outcomes to ranibizumab, with greater improvement in central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) subgroups and in fixed versus PRN regimens.
• Faricimab provided similar retinal thickness outcomes to other anti-vascular endothelial growth factor (VEGF) agents but was less effective than brolucizumab in reducing retinal thickness. Brolucizumab significantly reduced central subfield thickness compared to aflibercept and ranibizumab. Aflibercept exhibited superior retinal thickness reduction over ranibizumab and bevacizumab, particularly effective in diabetic macular edema (DME) and retinal vein occlusion (RVO).
• Faricimab required fewer injections annually compared to both fixed and flexible anti-VEGF regimens. Brolucizumab had reduced injection frequency in comparison to ranibizumab and aflibercept. Aflibercept generally required fewer injections than ranibizumab and PRN schedules.
• Faricimab demonstrated a safety profile comparable to other anti-VEGF agents for ocular adverse events and serious ocular adverse events, with a significant reduction in the risk of serious ocular adverse events compared to brolucizumab on a quarterly basis.
• Brolucizumab was associated with fewer serious adverse events overall compared to control groups but presented a higher incidence of serious ocular adverse events than aflibercept and ranibizumab; it was also noted for a higher incidence of severe ocular adverse events, including retinal vasculitis.
• Aflibercept exhibited a similar overall incidence of ocular and non-ocular adverse events relative to other anti-VEGF agents, maintaining a favorable safety profile with fewer ocular adverse events compared to ranibizumab and conbercept.
• Aflibercept demonstrated superior BCVA and CRT improvements in DME patients with poor baseline vision and showed greater BCVA and CRT efficacy in central RVO over ranibizumab, while ranibizumab showed comparable effectiveness to aflibercept in branch RVO; additionally, anti-VEGF agents, including aflibercept and bevacizumab, were effective in reducing retreatment rates and enhancing refractive outcomes in retinopathy of prematurity (ROP).