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    Data clearly demonstrates bevacizumab’s inferiority for DME

    Dr. KorobelnikAll three anti-vascular endothelial growth factor (anti-VEGF) agents that are commercially available have demonstrated efficacy for the treatment of diabetic macular edema (DME). However, it is clear from the results of clinical trials that outcomes with bevacizumab are not as good as those obtained using ranibizumab or aflibercept, according to Jean-François Korobelnik, MD. 

    Read the other side of the debate: Access, costs of bevacizumab key factors for DME therapy

    Providing the con position in the debate, “Bevacizumab is as Good as Ranibizumab and Aflibercept for DME,” Dr. Korobelnik reported that the Diabetic Retinopathy Clinical Research Network (DRCRnet) Protocol T randomized 660 adults with center-involving DME and baseline ETDRS visual acuity of 78 to 24 letters (Snellen equivalent ~20/32 to ~20/320) to intravitreal injection with aflibercept 2.0 mg (Eylea, Regeneron), bevacizumab 1.25 mg (Avastin, Genentech), or ranibizumab 0.3 mg (Lucentis, Genentech).

    Dr. Korobelnik is professor and chairman, department of ophthalmology, University Hospital of Bordeaux, France.

    Repeat injections were administered as needed, as often as every 4 weeks according to the protocol-specified algorithm, he added. Eyes with residual edema at 6 months were treated with focal laser unless the investigator felt it was unsafe.

    About half of the population had baseline visual acuity worse than 20/40. In that cohort, analyses of data from the 1-year visit showed statistically significant greater improvement from baseline visual acuity for eyes treated with aflibercept compared with the bevacizumab and ranibizumab groups.

    The mean visual acuity gain with aflibercept was about 19 letters compared with 13 letters for ranibizumab and 12 letters in the bevacizumab group, he added.'

    Same pattern found


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