Diabetic Macular Edema

Aflibercept, ranibizumab both effective for DME over 3 years

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Both aflibercept and ranibizumab are effective and safe for the treatment of diabetic macular edema (DME) over the course of 3 years, according to a study.

In this retrospective analysis, 534 eyes of 402 patients with DME from the Fight Retinal Blindness! Registry were included. Intravitreal injections of ranibizumab (0.5mg) were given in 267 eyes and intravitreal injections of aflibercept (2mg) in 267 patients.

There was no clinical difference at 3 years in the adjusted mean (95% CI) visual acuity (VA) change in the ranibizumab group (+1.3 [-0.1, 4.2] letters) and in the aflibercept group (+2.4 [-0.2, 5.1] letters).

There was a significant difference in the adjusted mean central subfield thickness throughout the 3-year period, with higher reductions in the aflibercept group (-114.4 [-134.4, -94.3] µm) compared with the ranibizumab group (-87.8 [-108.3, -67.4] µm).

In patients that had moderate (VA ≤68 ETDRS letters) baseline visual impairment, there was a fast improvement in VA in eyes treated with aflibercept up until 18 months of treatment compared with eyes treated with ranibizumab; after 18 months, improvement remained similar between groups until 36 months of treatment.

No apparent difference was noted when baseline visual impairment was mild (VA ≥69 ETDRS letters).

The rate of serious adverse events was low.

Gabrielle PH, Nguyen V, Creuzot-Garcher C, et al. Three-year treatment outcomes of aflibercept versus ranibizumab for diabetic macular edema: Data from the Fight Retinal Blindness! Registry. Retina. 2022 Feb 7. doi: 10.1097/IAE.0000000000003428. Epub ahead of print. PMID: 35174799.