Older patients with DME have weaker response to anti-VEGF treatment
Key takeaways:
- Improvement in visual acuity and central subfield thickness from baseline decreased with older age.
- Weak treatment response in both measures increased with older age.
Older patients with diabetic macular edema have a weaker response to anti-VEGF treatment, according to a presentation at Angiogenesis, Exudation, and Degeneration 2025.
Jennifer K. Sun, MD, MPH, said that in previous studies from the DRCR Retina Network, older patients with DME achieved less improvement in visual acuity.
“In our most recent Protocol AC, older age was associated with an increased risk of meeting the protocol-defined criteria for suboptimal treatment response, and older patients were therefore more likely to be switched from bevacizumab to aflibercept for treating DME,” she said.
Sun discussed a study, based on data from multiple DRCR Retina Network randomized clinical trials, that explored the link between patient age at baseline and response to anti-VEGF treatment based on visual acuity and central subfield thickness (CST).
The researchers looked at three treatment protocols (Protocol I: ranibizumab and deferred laser; Protocol T: aflibercept, bevacizumab or ranibizumab; and Protocol AC: aflibercept monotherapy) and divided patients into four age groups: those younger than 50 years, 50 to 59 years, 60 to 69 years, and 70 years and older. Mean change in visual acuity letter score and mean change in CST were assessed from baseline through 2 years, as well as the proportion of weak response in both measures.
Sun said the improvement in visual acuity and CST from baseline decreased with older age. Additionally, weak treatment response in both measures increased with older age.
“This trend persisted even after accounting for known differences in baseline characteristics,” Sun said. “We hope these findings are helpful to refine expectations regarding treatment outcomes when initiating therapy for DME with anti-VEGF drugs.”
Reference:
- Jaeb Center for Health Research. https://public.jaeb.org/drcrnet/pubs. Accessed March 3, 2025.
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Sun JK. Influence of age on DME treatment response. Presented at: Angiogenesis, Exudation, and Degeneration 2025; Feb 8, 2025 (virtual meeting).
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