VIDEO: Treatment options in diabetic eye disease

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Diabetic retinopathy is extremely prevalent throughout the world. But fortunately, with the advent of intravitreal anti-VEGF therapy, the management and treatment of diabetic eye disease has been revolutionized over the past decade. Progress continues to be made, especially with the FDA approval of two new medicines this past year. Faricimab (Vabysmo, Genentech), which is an intravitreal injection of a medicine that inhibits both VEGF and angiopoietin-2, was FDA approved over a year ago, and the results show that it’s highly effective and safe for the treatment of diabetic macular edema, which is swelling in the center of the retina. In those clinical trials, faricimab was found to be noninferior to aflibercept 2 mg (Eylea, Regeneron). In addition, faricimab could be dosed less frequently, and in the second year of follow-up, about 78% of faricimab-treated eyes could be treated every 12 weeks or greater, and that would help answer an important clinical need, which is to reduce the frequency of intravitreal injections.

More recently, the FDA has also approved aflibercept 8 mg (Eylea HD, Regeneron), which is a new formulation of aflibercept. Aflibercept 8 mg is four times the molar dose of the current aflibercept 2 mg. And the clinical trials for aflibercept 8 mg in diabetic macular edema showed that this new formulation met the primary endpoint and that it was noninferior to aflibercept 2 mg in visual acuity gains. But more importantly, eyes that were treated with aflibercept 8 mg could be dosed every 12 or 16 weeks with the same efficacious results but with fewer injections. In addition, at the second year, aflibercept 8 mg patients, up to 89% of those eyes could be treated every 12 weeks or every 16 weeks since the inception of the study. And that’s remarkable because this is one of the first agents that could really provide up to 16-week dosing and beyond in patients with diabetic macular edema. Those two agents provide new promising therapies for patients with diabetic macular edema.