OBJECTIVE: To evaluate the benefits and risks of aflibercept（AFL） in the treatment of diabetic macular edema（DME）

so as to provide evidence-based support for clinical decisions and practice. METHODS: According to the method of rapid health technology assessment（HTA）

PubMed

Embase

the Cochrane Library

CNKI

Wanfang Data and SinoMed were systematically retrieved with no limits on languages. The retrieval time was from the establishment of the database to Nov. 11 th

2021. HTA reports

systematic reviews/Meta-analyses

and pharmacoeconomic studies on the clinical efficacy and safety of AFL in the treatment of DME were included. The list of references included in the studies was supplemented by a manual search. The quality of included studies and reports was evaluated by using the AMSTAR and CHEERS tools. A comprehensive comparative and descriptive analysis of the included evidence was performed by comparing the study design and methodological quality of the included evidence. RESULTS: The initial screening obtained 1 912 publications

and 20 studies（12 systematic reviews/Meta-analysis and 8 pharmacoeconomic studies） of moderate or high quality were finally included. The results demonstrated that compared with ranibizumab（RAN）

bevacizumab（BEV） or laser photocoagulation（LP）

AFL showed superiority in vision improvement（as an outcome indicator of best corrected visual acuity

gain or loss of ETDRS letters） and reducing the number of injections. Compared with LP

AFL showed better improvement in anatomical parameters（central macular thickness or retinal thickness at macular fovea）. The safety of AFL in severe adverse events and eye severe adverse events was comparable to that of other drugs. Additionally

AFL had economic advantages compared with RAN in China. CONCLUSIONS: AFL is more effective than RAN

BEV or LP in the treatment of DME

and its safety is similar to that of RAN

BEV or LP

which has economic advantages in China. In the future

based on the population data in China

further research should be performed on the optimal regimen of AFL in the treatment of DME patients and the efficacy

safety and economics of long-term medication.