A study comparing three medications for treating diabetic macular edema showed that all three produced significant vision improvements after two years.
Two of the drugs—aflibercept (Eylea) and ranibizumab (Lucentis)—are approved by the U.S. Food and Drug Administration for treating diabetic macular edema.
The third, bevacizumab (Avastin), is a cancer drug commonly used as an off-label therapy for diabetic macular edema and other eye conditions. They are in a class of medication known as anti-VEGF (vascular endothelial growth factor) drugs.
Cost is the primary difference: Avastin is about $60 per dose, and the other two cost between $1,000 and $2,000 wholesale.
The study, which enrolled 660 participants, followed up on research that reported results from the first year. The three drugs produced improvement in vision similar to year one for patients with 20/40 vision or better at the start of treatment.
On average, vision improved from 20/40 to 20/25 with no substantial differences in the effectiveness of the drugs. For those with poor visual acuity at the start—20/50 or worse—vision improved to an average 20/32 to 20/40 with all three drugs.
At one year, Eylea outperformed Avastin and Lucentis. After two years, the difference between Eylea and Lucentis was statistically no different. The difference after two years between Eylea and Avastin was significant but small.
Talk to your eye doctor about your specific condition and to help you decide if you are a candidate for treatment of diabetic macular edema.
Source: Ophthalmology, Volume 123, page 1351, June 2016