Step strategy effective in treating diabetic eye disease
pharmafile | July 15, 2022 | News story | Medical Communications |
An NIH-funded clinical from the DRCR Retina Network suggests that a specific step strategy for patients with diabetic macular edema leads to positive vision outcomes in these patients.
The main complication of diabetic macular edema, fluid build-up in the retina causing vision loss, is commonly treated with anti-vascular endothelial growth factor (VEGF) drugs.
The study found that patients starting with a less expensive medicine, and then switching to a more expensive medicine if vision did not improve sufficiently, gave similar results to beginning treatment with the higher-priced drug.
“Our study showed that switching treatments when needed is a reasonable strategy,” commented Chirag Jhaveri, MD, Austin Research Centre for Retina, Texas, the lead study author. “Insurance companies often require clinicians to start with the less expensive treatment, so we really wanted to see how a specific treatment strategy using this approach would affect patient care.”
The trial was funded by the National Eye Institute (NEI), and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), both part of the National Insitutes of Health (NIH).
“While most participants on Avastin eventually switched to Eylea, they still had improvement during those initial weeks, even if they didn’t hit our pre-set benchmarks,” said Adam Glassman of the Jaeb Centre for Health Research and director of the DRCR Retina Network coordinating centre. “There are large cost disparities between these drugs, so differences in treatment strategies may have substantial cost implications.”
Diabetic macular edema is caused by diabetes-related alterations to retinal blood vessels. If untreated, vision loss can become permanent and progress to blindness.
“We’ve demonstrated here one method to managing a step treatment, where the outcomes are similar to the best existing treatment protocol with Eylea,” said Jennifer Sun, M.D., M.P.H., of Joslin Diabetes Centre and Harvard Medical School, Boston, and chair of diabetes initiatives for the DRCR Retina Network. “Any time we can add to a clinician’s toolbox, whether it’s a new medication or a new approach to using existing medications, as in this study, it’s a benefit for patients.”
