Ozurdex offers better anatomic outcomes, similar visual acuity vs. anti-VEGF

Issue: October 25, 2014

LONDON — For the treatment of patients with persistent diabetic macular edema, Ozurdex demonstrated better anatomic outcomes, but similar visual acuity results when compared with intravitreal Avastin, according to a speaker here.

“However, more eyes in the dexamethasone implant group lost vision,” Mark Gillies, MD, PhD, said at the Euretina Congress.

The multicenter, randomized clinical trial enrolled a total of 88 patients who were divided into two groups: those treated with intravitreal Avastin (bevacizumab, Genentech) and those treated with Ozurdex (dexamethasone 0.7 mg intravitreal implant, Allergan). Patients were followed for 1 year. The groups were homogeneous in terms of age, baseline visual acuity, gender distribution, duration of diabetes and IOP.

“The primary endpoint, a 10- or more letter gain, was achieved in a similar proportion, 40% vs. 42%, in the bevacizumab and dexamethasone implant groups,” Gillies said. “However, a loss of 10 or more letters was seen in 10% of the dexamethasone implant eyes, mostly due to un-operated cataract.”

At 12 months, central retinal thickness was significantly greater in the bevacizumab eyes, according to Gillies. Equally greater was the number of injections — on average, 8.6 compared with 2.7 — for the dexamethasone implant eyes.

Cataract surgery was the main adverse event, occurring in three of the dexamethasone implant eyes and in one bevacizumab-treated eye. The difference was not statistically significant, according to Gillies.

Increased IOP was seen in 26% of the dexamethasonetreated eyes, which received new glaucoma medications in 15% of the cases, Gillies said.

“It is a small study, and we are waiting for the results at 2 years to draw more interesting conclusions on steroid-induced cataract and cataract surgery,” Gillies said.

Disclosure: Gillies has no relevant financial disclosures.