February 20, 2015

Which drug is best for treating diabetic macular edema, an eye complication of diabetes?

How will the findings of a recent clinical trial affect our patients?

Retina as seen through a dialated pupilIllustration showing the retina as seen through a dialated pupil.

A clinical trial sponsored by the National Eye Institute compared three drugs used to treat diabetic macular edema: Eylea (aflibercept), Avastin (bevacizumab), and Lucentis (ranibizumab). The findings:

  • Eyela, on average, provided slightly greater visual improvement than the other two drugs when vision was 20/50 or worse at the start of the trial.  That is, Eylea improved vision one line more on the visual chart than the other drugs. These patients would be described as having “moderate or worse” vision loss.
  • When starting vision was 20/40 to 20/32, the three drugs resulted in similar average improvement.
  • There were no major differences in the safety of the three drugs.
  • The trial was funded by the National Eye Institute (NEI), part of the National Institutes of Health.

Thomas Gardner, M.D., M.S., Kellogg retina specialist, comments:

Most importantly, the study showed that all three drugs are safe and effective. The benefit of Eylea is modest when all patients in the study are considered. Results for any given patient may vary.

Moreover, Lucentis and Eylea are up to 10 times more expensive than Avastin.  We will evaluate each patient’s situation, but may consider the lower-cost drug first if all things are equal.

What is diabetic macular edema?

  • Diabetic macular edema (DME) can occur in people with diabetic retinopathy, a type of diabetic eye disease that can cause the growth of abnormal blood vessels in the retina. The macula is the area of the retina used when looking straight ahead, for tasks such as reading, driving, and watching television.
  • Macular edema, or swelling, occurs when fluid leaks from retinal blood vessels and accumulates in the macula, distorting vision. Macular edema can arise during any stage of diabetic retinopathy and is the most common cause of diabetes-related vision loss.
  • About 7.7 million Americans have diabetic retinopathy. Of these, about 750,000 have DME.

Learn more about diabetic retinopathy and diabetic macular edema.

Read the NEI news release: http://www.nih.gov/news/health/feb2015/nei-19.htm

Last Modified: Monday, 16-Mar-2015 09:22:49 EDT