The Best Medicine for Diabetic Macular Edema?

By Sondra Forsyth

Researchers have determined that the drug Eylea, used to treat diabetic macular edema, is more effective than two other medicines in severe cases. However, the other two drugs, Avastin and Lucentis,  also work well.

The study, published in the New England Journal of Medicine, is the first to compare the efficacy of the drugs.

“These findings will equip patients with the information they need to discuss with their doctors which drug to choose and will help guide protocols for clinicians using these drugs to treat patients with diabetic macular edema,” said Neil Bressler, M.D., past chair of the Diabetic Retinopathy Clinical Research Network and director of the Retina Division at Johns Hopkins Medicine.

Almost 750,000 people in the U.S. have diabetic macular edema, an eye disease that causes vision loss and is related to diabetes. It’s also becoming a major global health issue.

“Vision loss can be debilitating and isolating, especially for those who, in addition to vision loss, have the responsibility of managing diabetes. Discovering the best ways to prevent and treat vision loss is critical to a patient’s quality of life,” says Bressler. “We wanted to do our part by providing scientific comparative data to help patients and clinicians make more informed health decisions.”

In the study, investigators looked at 660 people with diabetic macular edema in 88 clinical trials. Each participant was randomly assigned to receive Eylea, Avastin or Lucentis via injection into the eyes. According to a news release from Johns Hopkins, participants had monthly evaluations and were given laser treatment if the illness showed no improvement after six months of injections.

One year after starting treatment, the majority of participants showed a substantial improvement. The university said in its news release that Eyelea improved vision on average almost four lines on an eye chart, Avastin improved vision on average of almost 2.5 lines and Lucentis improved vision on an average of almost three lines. At least 50 percent more people given Eylea compared with Avastin improved by three or more lines on the eye chart, and at least 30 percent more people given Eylea compared with Lucentis improved by three or more lines on the eye chart.

All three drugs reduced swelling of the macula, but Eylea and Lucentis reduced the swelling more than Avastin, the university said. Also, during the study, a smaller percentage of participants on Eylea (36 percent) underwent laser treatment for persistent edema compared with those on Avastin (56 percent) or Lucentis (46 percent).

The study was sponsored by the National Eye Institute, one of the National Institutes of Health.