Switching anti-VEGF therapy early after resistance may improve outcomes in DME
Switching to ranibizumab or aflibercept treatment after an inadequate response to bevacizumab injections improved visual and anatomical outcomes in patients with diabetic macular edema (DME), according to a study.
In this observational, retrospective, comparative, 80 patients (80 eyes) with DME who experienced an inadequate response to 3 consecutive bevacizumab injections, were switched to aflibercept (40 eyes) or ranibizumab (40 eyes).
At 12 months, the mean number of intravitreal injections in the aflibercept group and the ranibizumab group was 8.1 ± 1.8 and 8.9 ± 1.4, respectively. Mean central macular thickness also decreased in both groups, from 449.2 ± 69.3 µm to 311.0 ± 48.9 µm in the aflibercept group, and from 444.9 ± 109.2 µm to 316.3 ± 54.5 µm in the ranibizumab group.
In the aflibercept group, mean BVCA increased from 49.2 ± 11.1 ETDRS letters to 62.5 ± 9.9 letters. In the ranibizumab group, the increase was from 49.9 ± 12.0 ETDRS letters to 61.1 ± 9.1 letters.
Macular laser treatment was required in 17.5% and 22.5% of the aflibercept group and the ranibizumab group, respectively.
Ataş M, Ozsaygılı C, Bayram N, et al. Retrospective analysis of the efficacy of early switching from bevacizumab to aflibercept or ranibizumab in diabetic macular edema. Eur J Ophthalmol. 2022;11206721221137164. doi: 10.1177/11206721221137164. Epub ahead of print. PMID: 36330651.