Prevalence of Persistent Diabetic Macular Edema: Bevacizumab vs Aflibercept or Ranibizumab

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Through 24 weeks, persistent diabetic macular edema was more frequent with bevacizumab. <I>Photo Credit: Paul Whitten/Science Source.</I>
Through 24 weeks, persistent diabetic macular edema was more frequent with bevacizumab. Photo Credit: Paul Whitten/Science Source.

HealthDay News — For patients with diabetic macular edema (DME), persistence is more likely with bevacizumab than with aflibercept or ranibizumab, according to a study published online in JAMA Ophthalmology.

Neil M. Bressler, MD, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted post hoc analyses of a clinical trial. Among 546 patients, they examined outcomes of DME persisting at least 24 weeks after randomization to treatment with aflibercept, bevacizumab, or ranibizumab.

The researchers found that through 24 weeks, persistent DME was more frequent with bevacizumab than aflibercept or ranibizumab (65.6% vs 31.6% and 41.5%, respectively; P <.001 for aflibercept or ranibizumab versus bevacizumab; P =.05 for aflibercept versus ranibizumab).

Among eyes with persistent DME through 24 weeks, the rates of chronic persistent DME through 2 years were 44.2%, 68.2%, and 54.5% with aflibercept, bevacizumab, and ranibizumab, respectively (P =.03 for aflibercept vs bevacizumab; P =.41 for aflibercept vs ranibizumab; and P =.16 for bevacizumab vs ranibizumab).

The proportion with vs without chronic persistent DME through 2 years gaining at least 10 letters from baseline were 62% vs 63% with aflibercept (P =.88); 51% vs 54% with bevacizumab (P =.96); and 44% vs 65% with ranibizumab (P =.1) among eyes with persistent DME though 24 weeks.

"Regardless of diabetic macular edema persistence or anti-vascular endothelial growth factor agent, few eyes lost substantial vision," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

Reference

Bressler NM, Beaulieu WT, Glassman AR, et al. Persistent macular thickening following intravitreous aflibercept, bevacizumab, or ranibizumab for central-involved diabetic macular edema with vision impairment [published online February 1, 2018]. JAMA Ophthalmol. doi: 10.1001/jamaophthalmol.2017.6565

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