Diabetic Macular Edema

Treat-and-extend intravitreal aflibercept regimen leads to good outcomes in DME

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Favorable clinical outcomes were seen in patients with center-involved diabetic macular edema (DME) receiving a treat-and-extend (TAE) approach using intravitreal aflibercept, according to a study.

In this open-label interventional study, 45 patients with center-involved DME with best-corrected visual acuity (BCVA) of 73 to 24 Early Treatment Diabetic Retinopathy Study (ETDRS) letters and central retinal thickness (CRT) > 300 μm were treated with 5 monthly loading doses of 2 mg intravitreal aflibercept, followed by a TAE regimen with a 4-week increment/decrement interval over 48 weeks. The maximum interval was 12 weeks.

Baseline mean (SD) BCVA was 58.3 (11.9) letters; at 52 weeks, change from baseline was +8.3 (9.3) letters. Baseline mean (SD) CRT was 434.4 (116.8) μm; at 52 weeks, change from baseline was -138.2 (150.0) μm.

At 52 weeks, 22% of patients gained ≥ 15 letters, 14% of participants achieved ≥ 2-level improvement in diabetic retinopathy severity, and 51% demonstrated dry retina.

Disease stability was achieved in 87% of patients entering TAE at week 20. Maximum interval at week 52 was achieved in 89% of patients.

The mean (SD) number of injections was 7.7 (1.5) over 52 weeks.

Sheu SJ, Yang CH, Lai CC, et al. One-year outcomes of the treat-and-extend regimen using aflibercept for the treatment of diabetic macular edema. J Chin Med Assoc. 2021;doi: 10.1097/JCMA.0000000000000680. Epub ahead of print. PMID: 34974510.