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Aflibercept, bevacizumab or ranibizumab for diabetic macular oedema: recent clinically relevant findings from DRCR.net Protocol T.
Curr Opin Ophthalmol. 2017 Nov; 28(6):636-643.CO

Abstract

PURPOSE OF REVIEW

The aim of this study was to provide clinically relevant findings from the DRCR.net Protocol T, a multicentre randomized clinical trial comparing intravitreous aflibercept, repackaged (compounded) bevacizumab and ranibizumab for vision-impairing centre-involved diabetic macular oedema (DME).

RECENT FINDINGS

At 1 year, all three antivascular endothelial growth factor (anti-VEGF) drugs, on average, improved visual acuity. There was no difference among drugs in mean change in visual acuity from baseline among eyes with baseline Snellen equivalent visual acuity of 20/32 to 20/40, whereas aflibercept yielded superior vision outcomes among eyes with baseline visual acuity of 20/50 to 20/320. At 2 years, aflibercept remained superior, on average, to bevacizumab, but not ranibizumab, among eyes with baseline visual acuity of 20/50 to 20/320. Over 2 years, in post-hoc area-under-the-curve analysis, aflibercept vision outcomes were superior to bevacizumab or ranibizumab among these eyes. All three drugs had comparable ocular and systemic safety profiles. The substantial cost differential between aflibercept and bevacizumab raises challenges when safety and efficacy are at odds with cost-effectiveness results.

SUMMARY

When initial visual acuity loss is mild, there are no apparent differences, on average, among aflibercept, bevacizumab and ranibizumab for treating DME. When visual acuity loss is moderate or worse, aflibercept is more likely to improve visual acuity.

Authors+Show Affiliations

Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

28837425

Citation

Cai, Sophie, and Neil M. Bressler. "Aflibercept, Bevacizumab or Ranibizumab for Diabetic Macular Oedema: Recent Clinically Relevant Findings From DRCR.net Protocol T." Current Opinion in Ophthalmology, vol. 28, no. 6, 2017, pp. 636-643.
Cai S, Bressler NM. Aflibercept, bevacizumab or ranibizumab for diabetic macular oedema: recent clinically relevant findings from DRCR.net Protocol T. Curr Opin Ophthalmol. 2017;28(6):636-643.
Cai, S., & Bressler, N. M. (2017). Aflibercept, bevacizumab or ranibizumab for diabetic macular oedema: recent clinically relevant findings from DRCR.net Protocol T. Current Opinion in Ophthalmology, 28(6), 636-643. https://doi.org/10.1097/ICU.0000000000000424
Cai S, Bressler NM. Aflibercept, Bevacizumab or Ranibizumab for Diabetic Macular Oedema: Recent Clinically Relevant Findings From DRCR.net Protocol T. Curr Opin Ophthalmol. 2017;28(6):636-643. PubMed PMID: 28837425.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aflibercept, bevacizumab or ranibizumab for diabetic macular oedema: recent clinically relevant findings from DRCR.net Protocol T. AU - Cai,Sophie, AU - Bressler,Neil M, PY - 2017/8/25/pubmed PY - 2017/10/17/medline PY - 2017/8/25/entrez SP - 636 EP - 643 JF - Current opinion in ophthalmology JO - Curr Opin Ophthalmol VL - 28 IS - 6 N2 - PURPOSE OF REVIEW: The aim of this study was to provide clinically relevant findings from the DRCR.net Protocol T, a multicentre randomized clinical trial comparing intravitreous aflibercept, repackaged (compounded) bevacizumab and ranibizumab for vision-impairing centre-involved diabetic macular oedema (DME). RECENT FINDINGS: At 1 year, all three antivascular endothelial growth factor (anti-VEGF) drugs, on average, improved visual acuity. There was no difference among drugs in mean change in visual acuity from baseline among eyes with baseline Snellen equivalent visual acuity of 20/32 to 20/40, whereas aflibercept yielded superior vision outcomes among eyes with baseline visual acuity of 20/50 to 20/320. At 2 years, aflibercept remained superior, on average, to bevacizumab, but not ranibizumab, among eyes with baseline visual acuity of 20/50 to 20/320. Over 2 years, in post-hoc area-under-the-curve analysis, aflibercept vision outcomes were superior to bevacizumab or ranibizumab among these eyes. All three drugs had comparable ocular and systemic safety profiles. The substantial cost differential between aflibercept and bevacizumab raises challenges when safety and efficacy are at odds with cost-effectiveness results. SUMMARY: When initial visual acuity loss is mild, there are no apparent differences, on average, among aflibercept, bevacizumab and ranibizumab for treating DME. When visual acuity loss is moderate or worse, aflibercept is more likely to improve visual acuity. SN - 1531-7021 UR - https://www.unboundmedicine.com/medline/citation/28837425/Aflibercept_bevacizumab_or_ranibizumab_for_diabetic_macular_oedema:_recent_clinically_relevant_findings_from_DRCR_net_Protocol_T_ L2 - https://doi.org/10.1097/ICU.0000000000000424 DB - PRIME DP - Unbound Medicine ER -