Intravitreal Aflibercept for Diabetic Macular Edema

Korobelnik, J.-F.; Diana, V.; Schmidt‐Erfurth, Ursula; Boyer, David S.; Holz, Frank G.; Heier, Jeffrey S.; Midena, Edoardo; Kaiser, Peter K.; Terasaki, Hiroko; Marcus, Dennis M.; Nguyen, Quan Dong; Jaffe, Glenn J.; Slakter, Jason S.; Simader, Christian; Soo, Yuhwen; Schmelter, Thomas; Yancopouloš, George D.; Stahl, Neil; Vitti, Robert; Berliner, Alyson J.; Zeitz, Oliver; Metzig, Carola; Brown, David M.

doi:10.1016/j.ophtha.2014.05.006

Cited by 728 publications

(689 citation statements)

References 10 publications

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“…In 2013, an estimated 90% of retinal specialists in the United States reported using anti-VEGF therapy for initial management of vision loss from diabetic macular edema involving the macular center (2) .…”

Section: Proliferative Diabetic Retinopathy (Pdr)mentioning

confidence: 99%

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The Effect of Aflibercept and Ranibizumab in Patients with Diabetic Macular Edema: A comparative Study

Eid

Hamed²,

Hudieb³

2018

The Egyptian Journal of Hospital Medicine

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Background: Diabetic macular edema is one of the most significant causes of blindness and severe visual impairment in patients with diabetes, which can result in reduced quality of life. Three commonly used intravitreous VEGF inhibitors aflibercept, bevacizumab and ranibizumab have been shown to be beneficial and relatively safe for the treatment of diabetic macular edema, but only aflibercept and ranibizumab are approved by the Food and Drug Administration (FDA) for this indication. Aim of the Work: To compare between the effect of ranibizumab and aflibercept in patients with diabetic macular edema as a diabetic retinopathy complication that leads to visual impairment. Patients and Methods: A prospective study of 20 patients (20 eyes) was conducted in Al-Mouneer diabetic eye center with three times injection one month apart. The patients were divided into two groups, Group A was consisted of 10 patients who received ranibizumab as 0.5 mg (0.05ml of 10mg/ml solution) an intra vitreal injection. Group B was consisted of 10 patients who received aflibercept 2 mg (0.05mL of 40mg/ml solution) as an intra vitreal injection with follow up for three months. Results: A statistically significant difference over the time through BCVA and central macular thickness with ranibizumab. There was also a statistically significant difference over the time through BCVA, central macular thickness and IOP with aflibercept. Conclusion: There was more improvement in BCVA which was significant and more reduction in central macular thickness with ranibizumab than with aflibercept. Recommendations: Larger group studies to confirm our results; longer term study for the effect of ranibizumab and aflibercept injection on the central macular thickness and IOP and comparing the effect of single injection versus multiple injections. Searching for the causes of resistance or delayed response to the intravitreal injections in some patients.

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Section: Proliferative Diabetic Retinopathy (Pdr)mentioning

confidence: 99%

“…The worldwide prevalence of DM is predicted to grow to 430 million patients by 2030, and every one of them will be at risk of developing diabetic retinopathy (2) .…”

Section: Introductionmentioning

confidence: 99%

The Effect of Aflibercept and Ranibizumab in Patients with Diabetic Macular Edema: A comparative Study

Eid

Hamed²,

Hudieb³

2018

The Egyptian Journal of Hospital Medicine

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“…The safety and efficacy of aflibercept in managing DMO has been investigated in the phase II DME And VEGF Trap-Eye INvestigation of Clinical Impact (DAVINCI) trial (ClinicalTrials.gov: NCT00789477), the phase III VISTA/VIVID studies (ClinicalTrials.gov: NCT01363440/NCT01331681) and DRCR.net Protocol T [7,90,91]. DAVINCI and VISTA/VIVID demonstrated superiority of aflibercept in reducing CMT and improving visual acuity compared with ETDRS-guided laser photocoagulation [90,91].…”

Section: Anti-vegf Therapymentioning

confidence: 99%

Diabetic macular oedema: pathophysiology, management challenges and treatment resistance

Bahrami

Zhu

Hong³

et al. 2016

Diabetologia

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Diabetic macular oedema (DMO) is the leading cause of vision loss in patients living with diabetes. DMO results from hyperglycaemia-induced activation of pathways that lead to oxidative stress and release of cytokines, impairing the inner and outer blood-retinal barriers. Improved understanding of the pathophysiological mechanisms leading to DMO have led to the development of effective therapies, including vitreoretinal surgery, laser photocoagulation, intravitreal anti-vascular endothelial growth factor drugs and corticosteroids. Advances in imaging, including fluorescein angiography and optical coherence tomography, have also enhanced diagnosis and management of the condition. Despite these advances, there remain patients who do not respond completely to therapy, reflecting the complex pathophysiology of DMO. These patients may be considered treatment-resistant. In this review, we summarise the pathophysiology of DMO, as well as the available treatments and their mechanism of action. Additionally, we focus on treatment-resistant disease and review the literature on potential options for managing this complication of diabetes.

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“…Aflibercept can downregulate both VEGF-A and placental growth factor, which are synergistic for pathologic angiogenesis. The VISTA and VIVID studies, two randomized controlled trials, demonstrated the efficacy of intravitreal aflibercept 2 mg over the macular grid laser for 872 patients with center-involving DME for one-year follow-up [11]. The authors initially used monthly injections for five months, then treated ever 4 weeks (2q4) or every 8 weeks (2q8).…”

Section: Editorialmentioning

confidence: 99%

“…The pathophysiology of macular edema involves both the presence of inflammation and angiogenic stimulant regarding vascular endothelial growth factor (VEGF) [1]. Intravitreal injections of anti-VEGF, including ranibizumab [2][3][4][5][6][7][8], bevacizuamb [9], pegaptanib [10], aflibercept [11] are proven to be effective for managing DME. Intravitreal injections of corticosteroids, potent anti-inflammatory agents, such as fluocinolone acetonide implants (Retisert) [12], fluocinolone acetonide inserts (Iluvein) [13,14], dexamethasone implants [15,16], and triamcinolone acetonide [2] have been shown to be beneficial to DME.…”

mentioning

confidence: 99%

Long-Term Outcome of Approved Pharmacotherapy for Diabetic Macular Edema: A Review of Randomized Controlled Trials in Fluocinolone Acetonide Implants, Dexamethasone Implants, Aflibercept and Ranibizumab

Chen¹,

Wang²,

Wang

2015

J Clin Res Ophthalmol

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Intravitreal Aflibercept for Diabetic Macular Edema

Cited by 728 publications

References 10 publications

The Effect of Aflibercept and Ranibizumab in Patients with Diabetic Macular Edema: A comparative Study

The Effect of Aflibercept and Ranibizumab in Patients with Diabetic Macular Edema: A comparative Study

Diabetic macular oedema: pathophysiology, management challenges and treatment resistance

Long-Term Outcome of Approved Pharmacotherapy for Diabetic Macular Edema: A Review of Randomized Controlled Trials in Fluocinolone Acetonide Implants, Dexamethasone Implants, Aflibercept and Ranibizumab

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