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Early response to anti-VEGF therapy for DME may predict 3-year outcome
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SEATTLE — Optimal and suboptimal early responses to anti-VEGF therapy tended to predict long-term outcomes in patients treated for diabetic macular edema, according to data presented at the Association for Research in Vision and Ophthalmology meeting.
In an interview with Ocular Surgery News, Scott M. Whitcup, MD, discussed results of a post hoc analysis of data from the DRCR.net Protocol I study.
“The goal really was [to determine] how long and can you predict vision response to anti-VEGF therapy, and is an early response predictive of how you’re going to do longer term?” Whitcup said.
The analysis included 340 patients with DME who received three injections of Lucentis (ranibizumab, Genentech) over a period of 12 weeks. Patients were divided into three groups based on best corrected visual acuity gains at 12 weeks: less than five letters, five to nine letters, and 10 or more letters.
BCVA was re-evaluated at 3 years after initiation of treatment.
Results at 12 weeks showed gains of five letters in 135 patients (39.7%), five to nine letters in 79 patients (23.2%), and 10 or more letters in 126 patients (37.1%).
Over 3 years, patients with a limited early response to treatment had significantly lower rates of good vision compared with those who had a strong early response (P < .001).
Patients with a limited early response were significantly more likely to have a consistent suboptimal response for the duration of the study compared with those who had intermediate and strong early responses (P < .001).
“How you responded after three injections predicted how you were going to do for the rest of the study,” Whitcup said. “The take-home here is that some additional trials are needed to look at what [treatment] switching and combinations will lead to the best outcomes in that suboptimal response group.” – by Matt Hasson and David W. Mullin
Reference:
Whitcup SM, et al. Consistency of visual acuity responses to anti-VEGF therapy in diabetic macular edema patients: an analysis of DRCR.net Protocol I data. Presented at: Association for Research in Vision and Ophthalmology meeting; May 1-5, 2016; Seattle.
Disclosure: Whitcup reports he is a consultant for and has a personal financial interest in Allergan.