The clinical utility of aflibercept for diabetic macular edema

Michael W StewartDepartment of Ophthalmology, Mayo School of Medicine, Jacksonville, FL, USAAbstract: The treatment of center-involving diabetic macular edema (DME) has improved because of the proven efficacy of drugs that inhibit the effects of vascular endothelial growth factor (VEGF). The newest...

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Autor principal:	Stewart MW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/858c1642809b40a2ac5ad0401170055d
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spelling	oai:doaj.org-article:858c1642809b40a2ac5ad0401170055d2021-12-02T03:15:28ZThe clinical utility of aflibercept for diabetic macular edema1178-7007https://doaj.org/article/858c1642809b40a2ac5ad0401170055d2015-09-01T00:00:00Zhttps://www.dovepress.com/the-clinical-utility-of-aflibercept-for-diabetic-macular-edema-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Michael W StewartDepartment of Ophthalmology, Mayo School of Medicine, Jacksonville, FL, USAAbstract: The treatment of center-involving diabetic macular edema (DME) has improved because of the proven efficacy of drugs that inhibit the effects of vascular endothelial growth factor (VEGF). The newest anti-VEGF drug, aflibercept, has recently been approved by the United States Food and Drug Administration for the treatment of center-involving DME and for diabetic retinopathy in eyes with DME. In the pivotal Phase III VISTA and VIVID trials, intravitreal aflibercept 2 mg injections every 4 or 8 weeks (after 5 monthly loading doses) produced superior gains in BCVA compared to laser/sham injections. In the Diabetic Retinopathy Clinical Research Network Protocol T trial, which featured monthly anti-VEGF monotherapy for 6 months, followed by monthly pro re nata anti-VEGF injections with laser rescue therapy from months 6 through 12, aflibercept 2 mg monthly was superior to bevacizumab 1.25 mg and ranibizumab 0.5 mg in eyes with BCVA of 20/50 or worse (aflibercept versus bevacizumab: P<0.001; aflibercept versus ranibizumab: P=0.003), but the three regimens were comparable for eyes with VA of 20/40 or better. Only in the 20/50 or worse subgroup did aflibercept achieve clinical superiority (>5 letter difference) to bevacizumab. Each treatment regimen led to significant macular thinning, with aflibercept being superior to bevacizumab in both visual acuity subgroups (P<0.001 for each), but it was not statistically superior to ranibizumab in either group. In diabetic patients, aflibercept has an excellent safety profile that does not appear to differ from laser/sham or other VEGF inhibitory drugs.Keywords: aflibercept, bevacizumab, diabetic macular edema, ranibizumab, vascular endothelial growth factorStewart MWDove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2015, Iss default, Pp 473-482 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Specialties of internal medicine RC581-951
spellingShingle	Specialties of internal medicine RC581-951 Stewart MW The clinical utility of aflibercept for diabetic macular edema
description	Michael W StewartDepartment of Ophthalmology, Mayo School of Medicine, Jacksonville, FL, USAAbstract: The treatment of center-involving diabetic macular edema (DME) has improved because of the proven efficacy of drugs that inhibit the effects of vascular endothelial growth factor (VEGF). The newest anti-VEGF drug, aflibercept, has recently been approved by the United States Food and Drug Administration for the treatment of center-involving DME and for diabetic retinopathy in eyes with DME. In the pivotal Phase III VISTA and VIVID trials, intravitreal aflibercept 2 mg injections every 4 or 8 weeks (after 5 monthly loading doses) produced superior gains in BCVA compared to laser/sham injections. In the Diabetic Retinopathy Clinical Research Network Protocol T trial, which featured monthly anti-VEGF monotherapy for 6 months, followed by monthly pro re nata anti-VEGF injections with laser rescue therapy from months 6 through 12, aflibercept 2 mg monthly was superior to bevacizumab 1.25 mg and ranibizumab 0.5 mg in eyes with BCVA of 20/50 or worse (aflibercept versus bevacizumab: P<0.001; aflibercept versus ranibizumab: P=0.003), but the three regimens were comparable for eyes with VA of 20/40 or better. Only in the 20/50 or worse subgroup did aflibercept achieve clinical superiority (>5 letter difference) to bevacizumab. Each treatment regimen led to significant macular thinning, with aflibercept being superior to bevacizumab in both visual acuity subgroups (P<0.001 for each), but it was not statistically superior to ranibizumab in either group. In diabetic patients, aflibercept has an excellent safety profile that does not appear to differ from laser/sham or other VEGF inhibitory drugs.Keywords: aflibercept, bevacizumab, diabetic macular edema, ranibizumab, vascular endothelial growth factor
format	article
author	Stewart MW
author_facet	Stewart MW
author_sort	Stewart MW
title	The clinical utility of aflibercept for diabetic macular edema
title_short	The clinical utility of aflibercept for diabetic macular edema
title_full	The clinical utility of aflibercept for diabetic macular edema
title_fullStr	The clinical utility of aflibercept for diabetic macular edema
title_full_unstemmed	The clinical utility of aflibercept for diabetic macular edema
title_sort	clinical utility of aflibercept for diabetic macular edema
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/858c1642809b40a2ac5ad0401170055d
work_keys_str_mv	AT stewartmw theclinicalutilityofafliberceptfordiabeticmacularedema AT stewartmw clinicalutilityofafliberceptfordiabeticmacularedema
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The clinical utility of aflibercept for diabetic macular edema

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