Persistent DME more likely with bevacizumab treatment

(HealthDay)—For patients with diabetic macular edema (DME), persistence is more likely with bevacizumab than with aflibercept or ranibizumab, according to a study published online Feb. 1 in JAMA Ophthalmology.

Neil M. Bressler, M.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted post hoc analyses of a clinical trial. Among 546 patients, they examined outcomes of DME persisting at least 24 weeks after randomization to treatment with aflibercept, bevacizumab, or ranibizumab.

The researchers found that through 24 weeks, persistent DME was more frequent with bevacizumab than aflibercept or ranibizumab (65.6 versus 31.6 and 41.5 percent, respectively; P < 0.001 for aflibercept or ranibizumab versus bevacizumab; P = 0.05 for aflibercept versus ranibizumab). Among eyes with persistent DME through 24 weeks, the rates of chronic persistent DME through two years were 44.2, 68.2, and 54.5 percent with aflibercept, bevacizumab, and ranibizumab, respectively (P = 0.03 for aflibercept versus bevacizumab; P = 0.41 for aflibercept versus ranibizumab; and P = 0.16 for bevacizumab versus ranibizumab). The proportion with versus without chronic persistent DME through two years gaining at least 10 letters from baseline were 62 versus 63 percent with aflibercept (P = 0.88); 51 versus 54 percent with bevacizumab (P = 0.96); and 44 versus 65 percent with ranibizumab (P = 0.1) among eyes with persistent DME though 24 weeks.

"Regardless of diabetic macular edema persistence or anti-vascular endothelial growth factor agent, few eyes lost substantial vision," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.