Brolucizumab and aflibercept show comparable efficacy in treating diabetic macular edema

Both intravitreal brolucizumab (IVB) and intravitreal aflibercept (IVA) injections have demonstrated effectiveness and safety in treating central involved diabetic macular edema (CIDME), in a new case series.

The study showed that both treatments led to significant improvements in visual acuity and reductions in Central Foveal Thickness (CFT) over a 12-month period.

In the study, 45 treatment-naive eyes with CIDME were randomly assigned to either the IVB or IVA groups. Both groups received a loading phase of 3 consecutive intravitreal injections, followed by a personalized treat and extend (T&E) regimen.

At the 12-month follow-up, the IVA group received a mean of 7.25 ± 0.53 injections, while the IVB group received 6.3 ± 0.45 injections, demonstrating a statistically significant difference (P < 0.0001).

The IVA group exhibited a notable increase in mean BCVA from 0.66 ± 0.15 logMAR (50.9 ± 7.7 letters) to 0.41 ± 0.19 logMAR (63.7 ± 10.8 letters). Concurrently, mean central toveal thickness (CFT) decreased significantly from 441.2 ± 35.7 μm to 281.3 ± 18.4 μm.

Similarly, the IVB group experienced a substantial improvement in mean BCVA, progressing from 0.65 ± 0.16 logMAR (52.1 ± 7.9 letters) to 0.39 ± 0.17 logMAR (65.3 ± 8.7 letters). The mean CFT also saw a significant reduction, decreasing from 437.2 ± 41.9 μm to 275.5 ± 21.7 μm.

No significant difference was observed between the 2 groups concerning vision improvement and CFT reduction. However, a statistically significant discrepancy emerged in terms of the number of intravitreal injections administered. No ocular complications were reported across both treatment groups.

Reference
Elhamaky TR. Comparison between intravitreal brolucizumab and aflibercept in the treatment-naive central involved diabetic macular edema: One-year real-life case series. Eur J Ophthalmol. 2023;11206721231207459. doi: 10.1177/11206721231207459. Epub ahead of print. PMID: 37817540.