What studies have been done on the efficacy of VEGF inhibitors in the management of diabetic retinopathy?

Updated: Sep 02, 2021
  • Author: Abdhish R Bhavsar, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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A 4-year study by Epstein and Amrén found that after receiving a loading dose of ranibizumab (three monthly injections of 0.5 mg), best-corrected visual acuity in patients could be maintained with the drug administered on an as-needed basis. The number of required injections was low, the mean numbers during the first through fourth years being 4.7, 1.4, 0.7, and 0.9, respectively. [42]

Ranibizumab’s indication for diabetic retinopathy was expanded in 2017 to include all forms (ie, patients who have been diagnosed either with or without DME). Approval for treatment of diabetic retinopathy without DME followed an evaluation of the Diabetic Retinopathy Clinical Research Network's (DRCR.net) Protocol S study (n=305). The study assessed ranibizumab therapy in comparison with panretinal laser treatment in diabetic retinopathy patients with or without DME, with the analysis finding that retinopathy improved in patients in the ranibizumab group, either with or without DME. [43]

Bevacizumab has been used off-label to treat vitreous hemorrhage. In addition, this agent has been used to treat optic nerve or retinal neovascularization as well as rubeosis. [44, 45] In August, 2011, FDA announced a warning regarding several cases of intravitreal infections associated with repackaged bevacizumab that was potentially due to poor aseptic compounding technique. [46] Bevacizumab is commonly used to treat DME throughout the world and is a much lower cost alternative.

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