Anti-vascular endothelial growth factor (anti-VEGF) drugs for diabetic eye disease

The aim of this study was to evaluate anti-vascular endothelial growth factor (anti-VEGF) drugs for diabetic macular oedema. The main finding of the study was that these drugs prevent loss of sight and improve vision in these patients.

Patients with diabetes are at risk of developing an eye disease called diabetic retinopathy. Some patients with diabetic retinopathy can develop a thickening and swelling of a part of the eye, called diabetic macular oedema (DMO). This can lead to vision loss.

One type of treatment for DMO is anti-VEGF drugs. They are injected into the eye and reduce the swelling to prevent vision loss. There are three anti-VEGF drugs currently used: aflibercept (Eyelea), bevacizumab (Avastin) and ranibizumab (Lucentis). They slow the growth of new blood vessels, therefore reducing swelling. It is unknown which of the three drugs is the safest and most effective in patients with DMO.

This report summarized 24 different studies which investigated ranibizumab, bevacizumab, and aflibercept. The drugs were compared to no treatment, a placebo, laser treatment or to each other.

All three anti-VEGF drugs prevented vision loss and improved vision in patients with DMO. After 1 year, patients who were treated with ranibizumab were slightly less likely to have improved vision compared with aflibercept. Patients treated with ranibizumab and bevacizumab had similar results. Approximately 3-4 in 10 patients with DMO treated with these drugs could have improved vision by 3 or more lines. 

All three drugs have similar common and serious side effects such as causing diseases that lead to hospitalization, disability or death.

The authors concluded that all three anti-VEGF drugs were effective in preventing vision loss after 1 year of treatment. However, aflibercept showed slightly better results.

Currently, only aflibercept and ranibizumab have marketing authorization for the treatment of DMO.