Original ArticleRanibizumab or Aflibercept for Diabetic Macular Edema: Comparison of 1-Year Outcomes from the Fight Retinal Blindness! Registry
Section snippets
Design and Setting
This was a retrospective analysis of data tracked in a prospectively designed observational database, The Fight Retinal Blindness! Registry of real-world treatment outcomes of macular diseases.10 The registry has modules to collect data for age-related macular degeneration, retinal vein occlusion, and DME. The DME module was implemented in Australia, New Zealand, and Switzerland in April 2015. This has now expanded to other countries in Europe and Asia. Eyes receiving treatment for clinically
Study Participants
A total of 383 treatment-naive eyes (166 ranibizumab and 217 aflibercept) from 291 patients who started DME treatment with either ranibizumab or aflibercept from December 1, 2013, through June 1, 2018, were identified. Table 1 summarizes the baseline characteristics of the eyes in each of the groups. Patients receiving ranibizumab were significantly older than those receiving aflibercept (mean, 65.4 vs. 62.7 years; P = 0.04) and had diabetes for a longer duration (mean, 16 vs. 15 years; P
Discussion
This analysis in real-world clinical practice from a prospectively designed observational registry found that both aflibercept and ranibizumab improved vision and reduced macular thickness in eyes with DME after 1 year of treatment. Changes in VA for the 2 treatment groups, +1.4 letters for aflibercept versus 0.4 letters for ranibizumab (P = 0.4), were similar (adjusted mean difference, 1 letter) in eyes with initial VA of 69 letters or more (Snellen equivalent, 20/40), and a greater
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Cited by (38)
From randomised controlled trials to real-world data: Clinical evidence to guide management of diabetic macular oedema
2023, Progress in Retinal and Eye ResearchPersistent diabetic macular edema: Definition, incidence, biomarkers, and treatment methods
2023, Survey of OphthalmologyCitation Excerpt :Of note, in 166 DME eyes that initiated treatment with ranibizumab versus 217 eyes that initiated treatment with aflibercept, switching of treatment was uncommon within 12 months (19 eyes, 5%)19. Switching from ranibizumab to aflibercept, however, was significantly more frequent than vice versa (9% vs. 2%; p < 0.01) 19. Although VEGF role in the pathophysiology of macular edema is better known, it is now established that DME is driven partly by both the VEGF and angiopoietin-Tie2 pathways, as well as synergistic interplay between them.
Protein and polypeptide mediated delivery to the eye
2022, Advanced Drug Delivery ReviewsCitation Excerpt :Having demonstrated similar efficacy between the intravitreal administration of both anti-VEGF antibodies, another one-year retrospective study was recently reported comparing ranibizumab and aflibercept for diabetic macular edema. Bandari and coworkers [133] tracked the statistical changes of visual acuity changes and foveal central subfield thickness. The median injections of eyes receiving aflibercept received about two more injections than ranibizumab.
Cystoid Macular Edema
2022, Comprehensive PharmacologyVEGFR1 signaling in retinal angiogenesis and microinflammation
2021, Progress in Retinal and Eye ResearchCitation Excerpt :However, the hyperreflective spots cannot be used as a true proxy for inflammation until their cellular nature has been established more firmly. The target specificity of currently used anti-VEGF drugs might also yield some hints about the pathobiological function of VEGFR1 in DR. There are numerous studies in DME patients showing significant differences between ranibizumab and aflibercept when looking at certain clinical readouts, with aflibercept showing higher efficacy or longer lasting treatment effects (Bhandari et al., 2020; Jampol et al., 2016; Kaldirim et al., 2019; Ozkaya et al., 2020; Sarda et al., 2020; Shimizu et al., 2017). Furthermore, comparisons between aflibercept and bevacizumab* had similar outcomes (American Academy of Opthalmology, 2019; Virgili et al., 2018; Wells et al., 2015; Wells et al., 2016).
Management of treatment-naïve diabetic macular edema patients: Review of real-world clinical data
2024, European Journal of Ophthalmology
Supplemental material available at www.aaojournal.org.
Financial Disclosure(s): The author(s) have made the following disclosure(s): S.F.-B.: Consultant – Novartis, Allergan, Bayer, Specialised Therapeutics; Financial support – Novartis, Allergan, Bayer; Lecturer – Novartis, Allergan, Bayer.
H.M.: Consultant – Roche, Novartis, Allergan, Bayer; Financial support – Novartis, Bayer.
C.C.-G.: Consultant – Thea; Board membership – Allergan, Bayer, Novartis, Bausch & Lomb, Roche; Financial support – Horus, Novartis, Bayer; Lecturer – Novartis, Bayer.
F.V.: Consultant – Roche, Novartis, Bayer; Board membership – Novartis, Bayer, Roche; Financial support – Allergan; Lecturer – Novartis, Bayer.
M.G.: Consultant, Board membership, Financial support – Roche, Novartis, Allergan, Bayer; Inventor – software used to collect the data for this analysis.
D.B.: Consultant – Alcon; Financial support – Bayer, Novartis; Inventor – software used to collect the data for this analysis.
Fight Retinal Blindness! Investigators: Armadale Eye Clinic, Victoria (Dr. A. Cohn); CH Saint Brieuc, France (Dr. T. Guillaumie); CHU de Dijon, France (Dr. P. Gabrielle); CHU de Nice Pasteur, France (Mr. B. Walid); Canberra Hospital, Australian Capital Territory (Dr. J. Wells; Dr. R. Essex); Central Coast Eye Specialist, New South Wales (Dr. S. Young); Doncaster Eye Center, Victoria (Dr. L. Chow); Dorset Consultant Center, Victoria (Dr. H. Steiner); Eye Associates, New South Wales (Dr. M. Gillies); Eye Doctors Mona Vale, New South Wales (Dr. P. Beaumont); Fondazione IRCCS Ca’Granda—Ospedale Maggiore Policlinico, Italy (Dr. F. Viola); Gladesville Eye Specialists, New South Wales (Dr. S. Young); Hawthorn Eye Clinic, Victoria (Dr. E. Chong); Maison Rouge Ophthalmologic Center, France (Dr. G. Michel, Dr. B. Wolff); Marsden Eye Specialists, New South Wales (Dr. J. Arnold, Dr. T. Tan); Melbourne Retina Associates, Victoria (Dr. A. Cohn); New England Eye Centre, New South Wales (Dr. M. Morgan); North Queensland Retina, Queensland (Dr. I. Reddie); Retina & Macula Specialists (Hurstville), New South Wales (Dr. S. Nothling); Retina & Macula Specialists (Miranda), New South Wales (Dr. R. Chalasani); Retina Associates, New South Wales (Dr. S. Fraser-Bell, Dr. A. Fung); Royal Free London NHS Foundation Trust, United Kingdom (Dr. H. Mehta); Specialist Eye Group, Victoria (Dr. A. Cohn); St John of God Hospital Geelong, Victoria (Dr. P. Lockie); Tamworth Eye Centre, New South Wales (Dr. P. Hinchcliffe); University Hospital Zurich, Switzerland (Dr. D. Barthelmes); and Victorian Eye Surgeons, Victoria (Dr. A. Cohn).
The Fight Retinal Blindness! Project is supported by a grant from the Macular Disease Foundation Australia and unrestricted educational grants from Bayer and Novartis.
HUMAN SUBJECTS: Human subjects were included in this study. The human ethics committees at the Royal Australian and New Zealand College of Ophthalmologists Human Research Ethics Committee, the South Eastern Sydney Local Health District Human Research Ethics Committee, the French Institutional Review Board (Société Française d’Ophtalmologie Institutional Review Board), the Ethics Committee of the University of Milan, the Cantonal Ethics Committee Zurich, and the Caldicott Guardian at the Royal Free London NHS Foundation Trust approved the study. All research adhered to the tenets of the Declaration of Helsinki. Consent was obtained in countries where required.
No animal subjects were included in this study.
Author Contributions:
Conception and design: Bhandari, Nguyen, Gillies, Barthelmes
Analysis and interpretation: Bhandari, Nguyen, Gillies
Data collection: Bhandari, Fraser-Bell, Mehta, Viola, Baudin, Gabrielle, Creuzot-Garcher, Gillies, Barthelmes
Obtained funding: Fraser-Bell, Mehta, Creuzot-Garcher, Viola, Gillies, Barthelmes
Overall responsibility: Bhandari, Nguyen, Fraser-Bell, Mehta, Viola, Baudin, Gabrielle, Creuzot-Garcher, Gillies, Barthelmes