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Multicenter Study
. 2023 Jan 30;59(2):263.
doi: 10.3390/medicina59020263.

Real Life Multicenter Comparison of 24-Month Outcomes of Anti-VEGF Therapy in Diabetic Macular Edema in Turkey: Ranibizumab vs. Aflibercept vs. Ranibizumab-Aflibercept Switch

Murat Kucukevcilioglu  1 , Yağmur Seda Yeşiltaş  1 , Ali Hakan Durukan  1 , Nurten Unlu  2 , Mehmet Onen  3 , Mehmet Numan Alp  3 , Defne Kalayci  3 , Mehmet Akif Acar  3 , Mehmet Ali Sekeroglu  4 , Mehmet Citirik  4 , Ayse Gul Kocak Altintas  4 , Dicle Hazirolan  2 , Pinar Cakar Ozdal  4 , Yasin Toklu  3 , Tolga Bicer  5 , Nagihan Ugurlu  3 , Ozlem Budakoglu  4 , Zeliha Yazar  3 , Nil Irem Ucgun Zeki  3 , Kurtulus Serdar  6 , Sibel Doguizi  4 , Yasemin Ozdamar Erol  4 , Cemile Ucgul Atilgan  4 , Mucella Arikan Yorgun  3 , Dilek Ozcelik Soba  4 , Nilufer Berker  4 , Ceyda Baskan  3
Affiliations
Multicenter Study

Real Life Multicenter Comparison of 24-Month Outcomes of Anti-VEGF Therapy in Diabetic Macular Edema in Turkey: Ranibizumab vs. Aflibercept vs. Ranibizumab-Aflibercept Switch

Murat Kucukevcilioglu et al. Medicina (Kaunas). .

Abstract

The aim of this study was to compare the outcomes of diabetic macular edema (DME) treated with aflibercept (AFB) or ranibizumab (RNB) only, and after switching from RNB to AFB. This was a retrospective, real-world, multicenter (7 cities) 24 month study. Overall, 212 eyes in the AFB group, 461 in the RNB group, and 141 in the RNB to AFB group were included. The primary endpoints were differences in visual acuity (VA) and central macular thickness (CMT) from baseline to the final visit. The secondary outcomes were the percentage of eyes that achieved ≥10 letters gain and ≥10 letters loss in vision at month 12 and 24, and the percentage of eyes that achieved a thinning of ≥20% in CMT at month 3 and month 6. The results showed that VA did not significantly differ at baseline (AFB: 0.62 ± 0.38, RNB: 0.61 ± 0.36, RNB to AFB: 0.61 ± 0.38), at checkpoints, or at the final visit (AFB: 0.46 ± 0.38, RNB: 0.5 ± 0.37, RNB to AFB: 0.53 ± 0.36) (p > 0.05). Though the mean CMT at baseline was significantly thicker in the RNB to AFB group (479 ± 129.6 μm) when compared to the AFB (450.5 ± 122.6 μm) and RNB (442 ± 116 μm) groups (p < 0.01), similar measurements were obtained after 12 months. The percentages of eyes that gained or lost ≥10 letters in the AFB, RNB, and RNB to AFB groups at year 1 and 2 were similar, as was the percentages of eyes that demonstrated ≥20% CMT thinning at month 3 and 6. Our study showed similar visual improvements in non-switchers (AFB and RNB groups) and switchers (RNB to AFB group) through 2 years follow-up, however, AFB patients required fewer injections, visits, or need for additional treatments.

Keywords: anti-vascular endothelial growth factor (anti-VEGF); diabetic macular edema; macular thickness; real-world; switch; visual acuity.

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Conflict of interest statement

The authors declare no conflict to interest.

Figures

Figure 1
Figure 1
The percentages of eyes that achieved more than 10 letters gain and more than 10 letters loss in vision at month 12 and 24 among study groups.
Figure 2
Figure 2
The percentages of eyes that demonstrated a decrease in central macular thickness (CMT) ≥20% at month 3 and month 6 among study groups.
See this image and copyright information in PMC

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