comparative effectiveness of ranibizumab and bevacizumab in the treatment of diabetic retinopathy: A Systematic Review and Meta-Analysis

ODUBIA, James Success and AKINRINADE, Samson Shina and AGBESEYI, Samuel Olaniyi and SOWUNMI, Adekoyejo Ayomide and NKAROIJO, Daniel Ataije and AJILEYE, Sunday Ezekiel (2025) comparative effectiveness of ranibizumab and bevacizumab in the treatment of diabetic retinopathy: A Systematic Review and Meta-Analysis. World Journal of Biology Pharmacy and Health Sciences, 23 (2). pp. 419-433. ISSN 2582-5542

Background: Diabetic retinopathy (DR) is a leading cause of vision loss globally. While panretinal photocoagulation has been a long-standing treatment, intravitreal anti-VEGF agents such as ranibizumab have demonstrated superior efficacy, establishing it as a first-line therapy. However, bevacizumab, though off-label, is widely used due to its lower cost and comparable pharmacological profile. This study systematically reviewed and meta-analysed randomized controlled trials (RCTs) published between 2012 and 2021 to compare the therapeutic effectiveness of ranibizumab and bevacizumab in improving visual outcomes among patients with DR. Specific objectives included: (1) rigorous selection and appraisal of eligible RCTs; (2) systematic extraction of trial data; (3) pooled statistical analysis using odds ratios and relative risks; and (4) critical interpretation of findings for clinical practice. Methods: A quantitative approach was employed, using systematic review and meta-analysis in line with PRISMA guidelines. Data were analysed with RevMan 5.4 software, and statistical comparisons were made using odds ratios and relative risk analysis. Results: Pooled analysis of eligible trials demonstrated no heterogeneity (I² = 0%) and revealed a p-value of 0.74, indicating bevacizumab was superior to ranibizumab in improving visual outcomes. Conclusion: Bevacizumab demonstrates greater therapeutic effectiveness than ranibizumab in the treatment of DR. Given its lower cost and accessibility, bevacizumab should be prioritized in clinical practice, particularly in resource-limited settings. Increased awareness and adoption by healthcare professionals are recommended to optimize DR management.