Clinical Evidence on Acanthamoeba Keratitis Treatments: Systematic Literature Review
Author(s)
Tofani L1, Bodicoat D2, Alves A3, Arteaga A4, Papa V1
1SIFI S.p.A., Aci Sant'Antonio (CT), CT, Italy, 2HEOR Value Hub, Lanaken, Belgium, 3HEOR Value Hub, Lanaken, VLI, Belgium, 4HEOR Value Hub, milan, MI, Italy
Presentation Documents
OBJECTIVES:
Acanthamoeba keratitis (AK) is a rare, severe, progressive corneal infection with no approved medicinal treatments. To understand the existing evidence-base on AK treatments, we conducted a systematic literature review (CRD42022345288).METHODS:
Articles with ≥5 participants with AK were included. Interventions of interest were any agent with anti-amoebic activity administered as eye-drops or orally. No restrictions were placed on the type of control. The main outcomes of interest were clinical resolution and best-corrected visual acuity (BCVA). Electronic databases (1992-2022), conference abstracts (2017-2022), and manufacturer websites were searched. Risk of bias assessments used external tools. A narrative synthesis was conducted.RESULTS:
The 37 eligible studies (2043 patients) included at least 31 different treatment regimens and were mostly observational studies (n=35). For quality, 56.8% studies were rated as good, 27.0% as fair, and 16.2% as poor. Data were extracted for 24 different efficacy and safety outcomes. Clinical resolution was reported in 20 studies and BCVA in 28 studies. Outcome definitions and timings varied markedly between studies, and this contributed to wide ranges of estimates for these outcomes. Clinical resolution ranged from 4% to 100%, but its definition and time of measurement differed across the studies, which makes comparison between them difficult. Also, the percentages of patients with a follow-up BCVA of 6/12 or better ranged from 29% to 100%, but it was unclear whether BCVA was measured before or after an eventual corneal surgery.CONCLUSIONS:
A considerable body of evidence is available and no published evidence syntheses were identified, suggesting that the latter are needed to establish efficacy estimates for key treatments and outcomes. However, substantial differences in treatment regimens and outcome definitions need to be appropriately accounted for when synthesizing this evidence. This review highlights the importance of standard outcome definitions to better assess comparability of treatments for AK.Conference/Value in Health Info
2023-11, ISPOR Europe 2023, Copenhagen, Denmark
Value in Health, Volume 26, Issue 11, S2 (December 2023)
Code
SA59
Topic
Study Approaches
Topic Subcategory
Clinical Trials, Literature Review & Synthesis
Disease
Infectious Disease (non-vaccine), Rare & Orphan Diseases, Sensory System Disorders (Ear, Eye, Dental, Skin)