HealthDay News — For treatment of diabetic macular edema involving the center of the macular, 2-year outcomes are similar for those treated with aflibercept monotherapy and with bevacizumab first then a switch to aflibercept in cases of suboptimal response, according to a study published online July 14 in the New England Journal of Medicine to coincide with the annual meeting of the American Society of Retina Specialists, held from July 13 to 16 in New York City.

Chirag D. Jhaveri, MD, from the Retina Consultants of Austin in Texas, and colleagues randomly assigned eyes in adults with diabetic macular edema involving the macular center and a visual-acuity letter score of 24 to 69 to receive 2.0mg of intravitreous aflibercept or 1.25mg of intravitreous bevacizumab. Eyes in the bevacizumab group were switched to aflibercept beginning at 12 weeks if protocol-specified criteria were met. A total of 312 eyes were randomly assigned: 158 to aflibercept monotherapy and 154 to bevacizumab first.

The researchers found that 70% of the eyes in the bevacizumab-first group were switched to aflibercept therapy during the two-year period. The mean improvement in visual acuity was 15.0 and 14.0 letters in aflibercept-monotherapy and bevacizumab-first groups, respectively. At 2 years, the groups had similar mean changes in visual acuity and retinal central subfield thickness. Serious adverse events were more frequent in the aflibercept-monotherapy group.

“These results expand our understanding of how and whether clinical outcomes differ with the use of various antivascular endothelial growth factor treatment strategies for diabetic macular edema,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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