Study Compares 3 Drugs for Diabetic Macular Edema

A recent study compared 3 drugs for the treatment of diabetic macular edema (DME)—bevacizumab, afilbercept, and ranibizumab—to determine which is the most effective treatment for patients with moderate vision loss [N Engl J Med. 2015; DOI:10.1056/NEJMoa1414264].

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The study was funded by the US National Eye Institute (NEI). According to the NEI, about 750,000 Americans suffer from DME, which occurs in people with diabetic retinopathy, of which approximately 7.7 million people suffer from.

Current treatment regimens consist of monthly intraocular injections of bevacizumab, afilbercept, and ranibizumab, in addition to laser therapy.

The new study included 660 people with a mean age of 61 years who had DME. All patients had been diagnosed with either type 1 or type 2 diabetes for an average of 17 years.

Patients were randomly assigned to receive 1 of the 3 drugs and had their vision assessed at 1-year. Among patients whose vision was 20/50 or worse at the start of the trial, those who took afilbercept had greater vision improvement than those who took bevacizumab or ranibizumab, according to the study.

However, the researchers stressed that all 3 drugs offered similar vision improvement in patients whose vision at the start of the study was rated as anywhere from 20/40 to 20/32. The 3 drugs were also similar in terms of safety.

"This comparative effectiveness study will help doctors and patients make informed decisions when choosing treatments for diabetic macular edema,” said Paul Sieving, MD, PhD, director, NEI, in an agency news release.

Afilbercept, however, is the most costly option of the 3 treatments. Afilbercept costs approximately $1900 per injection, while ranibizumab costs $1200 and bevacizumab costs $70.—Kerri Fitzgerald