Patients With DME Who Switched to Eylea Had Better Vision After a Year

Patients with diabetic macular edema (DME) who switched from Lucentis to Eylea reported had better vision after 12 months, according to results of a recent study appearing in the European Journal of Opththalmology.

Marko Lukic, a consulting ophthalmologist at Moorfields Eye Hospital in London, England, led a research team that examined results from 90 eyes, involving 67 patients who had been receiving anti-vascular endothelial growth factor. The patients were enrolled in the National Health Service in the United Kingdom. The researchers’ goal was to assess both vision and anatomical changes following treatment with Eylea (aflibercept, Regeneron), after patients had previously received Lucentis (ranibizumab).

In this retrospective cohort study, patients had visual acuity and optical coherence tomography scans performed at baseline and at 12 months after they received the first injection of Eylea. The main outcomes measures were visual acuity, based on the Early Treatment Diabetic Retinopathy Study (ETDRS) letters scale, and the mean change in macular volume and central foveal thickness, or average thickness of the macula.

In the study, the mean visual acuity (SD) at baseline was 63 (15.78); the mean (SD) central foveal thickness was 417.7 (158.4) μm and the mean macular volume was 9.96 (2.44) mm3. After 12 months, the mean change in visual acuity was +4 ETDRS letters (P = .0053). The mean change in macular volume was a decline of 1.53 mm3 in the switched group, (P = .21), while the mean change in thickness was a decline of 1.36 μm (P = .69).

“There was a significant improvement in visual acuity and in anatomical outcomes in the switched group at 12 months after commencing treatment with aflibercept for diabetic macular edema,” the authors concluded.

These real-world findings produced results for DME that are similar to those seen in earlier studies on switching products in age-related macular degeneration. A review article in Survey of Ophthalmology found studies show that patients who switch to Eylea after using Lucentis or Avastin report statistically significant reductions in retinal thickness. When these improvements are seen, patients can have injections at less frequent intervals.

“Eylea, when injected every eight weeks (after an initial monthly injection regimen for three months), was shown to be indistinguishable from Lucentis every four weeks in the VIEW trials,” wrote Joshua Dunaief, MD, PhD, an ophthalmology professor at the University of Pennsylvania, in a 2017 article comparing the therapies. “However, injections of Eylea every eight weeks has not been compared to Lucentis every eight weeks in a clinical trial.”