Questo studio sulla maculopatia diabetica ha messo a confronto l’efficacia nel tempo di diversi farmaci anti-VEGF iniettati negli occhi dei pazienti diabetici, misurando la capacità di migliorare il visus e di ridurre lo spessore maculare.
I risultati riportati confermano ciò che la pratica clinica aveva già suggerito: negli occhi affetti da forme lievi non vi sono importanti differenze tra Eylea, Avastin e Lucentis, ma negli occhi affetti da forme gravi, l’iniezione di Eylea porta a risultati decisamente migliori.
The Diabetic Retinopathy Clinical Research Network
New England Journal of Medicine
February 18, 2015
Methods At 89 clinical sites, we randomly assigned 660 adults (mean age, 61±10 years) with diabetic macular edema involving the macular center to receive intravitreous aflibercept at a dose of 2.0 mg (224 participants), bevacizumab at a dose of 1.25 mg (218 participants), or ranibizumab at a dose of 0.3 mg (218 participants). The study drugs were administered as often as every 4 weeks, according to a protocol-specified algorithm. The primary outcome was the mean change in visual acuity at 1 year.
Results From baseline to 1 year, the mean visual-acuity letter score (range, 0 to 100, with higher scores indicating better visual acuity; a score of 85 is approximately 20/20) improved by 13.3 with aflibercept, by 9.7 with bevacizumab, and by 11.2 with ranibizumab. Although the improvement was greater with aflibercept than with the other two drugs (P0.50 for each pairwise comparison). When the initial letter score was less than 69 (approximately 20/50 or worse), the mean improvement was 18.9 with aflibercept, 11.8 with bevacizumab, and 14.2 with ranibizumab (P
Conclusions Intravitreous aflibercept, bevacizumab, or ranibizumab improved vision in eyes with center-involved diabetic macular edema, but the relative effect depended on baseline visual acuity. When the initial visual-acuity loss was mild, there were no apparent differences, on average, among study groups. At worse levels of initial visual acuity, aflibercept was more effective at improving vision. (Funded by the National Institutes of Health; ClinicalTrials.gov number, NCT01627249.)