DEFINING "STRONG" VERSUS "WEAK" RESPONSE TO ANTIVASCULAR ENDOTHELIAL GROWTH FACTOR TREATMENT FOR CENTER-INVOLVED DIABETIC MACULAR EDEMA.

Abstract

BACKGROUND/PURPOSE:

To define "strong" versus "weak" antivascular endothelial growth factor (anti-VEGF) treatment response in eyes with center-involved diabetic macular edema (CI-DME).

METHODS:

Exploratory analyses of three DRCR Retina Network randomized trials of eyes with CI-DME treated with aflibercept, bevacizumab, or ranibizumab. Thresholds of 5-, 10-, and 15-letter gain defined strong visual acuity (VA) response when baseline VA was 20/25-20/32, 20/40-20/63, or 20/80-20/320, respectively. Thresholds of 50, 100, or 200- µ m reduction defined strong anatomical response when baseline central subfield thickness (CST) was <75, ≥75 to <175, or ≥175- µ m above standard thresholds. Additional thresholds from regression equations were calculated.

RESULTS:

At 24 weeks, outcomes for strong response were achieved by 476 of 958 eyes (50%) for VA and 505 eyes (53%) for CST. At 104 weeks among the 32% of eyes with strong VA and CST response at 24 weeks, 195 of 281 (69%) maintained strong VA and CST response, whereas 20 (7%) had neither strong VA nor strong CST response. Outcomes rates were similar across protocols and when defined using regression equations.

CONCLUSION:

These phenotypes are suitable for efforts to identify predictive biomarkers for response to anti-VEGF therapy for DME and might facilitate comparison of treatment response among diverse cohorts with DME.

• Authors: Jennifer K Sun, Wesley T Beaulieu, Michele Melia, Frederick L Ferris 3rd, Raj K Maturi, Jared S Nielsen, Sharon D Solomon, Lee M Jampol, DRCR Retina Network
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 43 Issue 4 Pg. 616-623 (04 01 2023) ISSN: 1539-2864 [Electronic] United States
• PMID: 36728692 (Publication Type: Journal Article)

Chemical References

• Endothelial Growth Factors
• Ranibizumab
• Bevacizumab
• aflibercept
• Angiogenesis Inhibitors

Topics

• Macular Edema (drug therapy)
• Diabetic Retinopathy (drug therapy)
• Endothelial Growth Factors (administration & dosage, therapeutic use)
• Ranibizumab (therapeutic use)
• Bevacizumab (therapeutic use)
• Angiogenesis Inhibitors (therapeutic use)
• Treatment Outcome