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More inflammation observed after aflibercept vs. ranibizumab injection
VANCOUVER, British Columbia — While eye pain outcomes were similar within a week of injection of either aflibercept or ranibizumab in patients with diabetic macular edema, more anterior chamber inflammation was seen in patients receiving aflibercept, although not to a level of statistical significance.
“Anterior chamber inflammation occurred more frequently in patients receiving aflibercept compared to ranibizumab, but the difference was not statistically significant. There was no difference in the vitreous inflammation and the numbers were quite small,” Nikolas J.S. London, MD, said at the American Society of Retina Specialists annual meeting, where he reported results of the SOLAR trial.
The randomized, prospective clinical trial included 100 patients with diabetic macular edema randomized 1:1 to open-label Lucentis (ranibizumab, Genentech) 0.3 mg or Eylea (aflibercept, Regeneron) 2.0 mg intravitreal injection. Patients could be either treatment-naive or not; previously treated patients could not have received an injection within the previous 90 days. Intraocular inflammation and pain were compared between the two groups during two follow-up visits: 24 to 48 hours after treatment and 5 to 7 days after treatment.
The incidence of anterior chamber inflammation was greater in the aflibercept patients at the first visit, 20%, compared with 12% of patients in the ranibizumab group. The difference was not statistically significant, London said.
At the first visit, absence of pain was equal -- 22 patients each cohort. However, 18% of aflibercept patients compared with 14% of ranibizumab patients reported severe pain. Percentage of patients reporting severe pain at the second visit was 6% and 4%, respectively.
“These findings suggest aflibercept treated eyes may be more likely to have subclinical post-injection inflammation. Further studies with larger sample sizes will be necessary to verify this observation,” London said. – by Robert Linnehan
Reference: London NJS. Prospective evaluation of pain and inflammation following injection of aflibercept or ranibizumab in patients with diabetic macular edema: SOLAR study. Presented at: American Society of Retina Specialists annual meeting; July 20-25, 2018; Vancouver, British Columbia.
Disclosure: London reports he is a consultant for Alcon, Alimera and Genentech, and receives research support from Allergan, Apellis, Clearside, Genentech and Regeneron.