HealthDay News — For patients with diabetic macular edema (DME), visual acuity (VA) improves over two years with treatment with different anti-vascular endothelial growth factor (VEGF) agents, according to a study published online February 27 in Ophthalmology.

John A. Wells, MD, from the Palmetto Retina Center in Columbia, SC, and colleagues provided two-year results comparing VEGF agents for DME. Six hundred sixty participants with DME-related VA impairment were randomized to 2.0-mg aflibercept, 1.25-mg repackaged bevacizumab, or 0.3-mg ranibizumab intravitreous injections. If DME persisted, focal/grid laser photocoagulation was added after six months.

The researchers found that the median number of injections were 15, 16, and 15 over two years in the aflibercept, bevacizumab, and ranibizumab groups, respectively, with five, six, and six injections, respectively, in year two. There was an improvement in the VA by 12.8, 10.0, and 12.3 letters, respectively, at two years. There was variation in treatment group differences by baseline VA (P = 0.02 for interaction). The mean improvement was 18.3, 13.3, and 16.1 letters, respectively, with worse baseline VA (aflibercept versus bevacizumab, P = 0.02; aflibercept versus ranibizumab, P = 0.18; ranibizumab versus bevacizumab, P = 0.18). The mean improvement was 7.8, 6.8, and 8.6 letters, respectively, with better baseline VA (P > 0.10 for pairwise comparisons).

“Visual acuity outcomes were similar for eyes with better baseline VA,” the authors write. “Among eyes with worse baseline VA, aflibercept had superior two-year VA outcomes compared with bevacizumab.”

Several authors disclosed financial ties to pharmaceutical companies, including the manufacturers of aflibercept, bevacizumab, and ranibizumab.

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