Eylea, Avastin Or Lucentis - Which Is More Efficacious In Treating DME?

(RTTNews) - The debate over three drugs for diabetic macular edema, Eylea, Avastin and Lucentis, has been going on for quite some time.

A two-year clinical trial that compared the three drugs suggests that while all three are effective treatments for diabetic macular edema (DME), Eylea certainly has an edge over Avastin in DME patients with moderate or worse vision loss, say with a visual acuity of 20/50 or worse. (If a person has a visual acuity of 20/50, it means that he/she must stand as close as 20 feet to see what a person with normal vision can see standing 50 feet away).

The study, conducted by the Diabetic Retinopathy Clinical Research Network, enrolled 660 people with DME - with one half of the participants having a visual acuity in the range of 20/32 to 20/40 and the other half having a visual acuity of 20/50 or worse. The participants were randomized to receive Eylea, Avastin or Lucentis. If even after six months, there was no improvement in DME, the participants were subjected to laser treatment.

According to the trial results, in those participants who had 20/40 or better vision at the trial's start, all three drugs improved vision similarly on an eye chart, wherein the visual acuity improved to 20/25 from baseline over 2 years.

However, in participants with 20/50 or worse vision at the trial's start, Eylea had an advantage over Avastin both at the one- and two-year time points. While Eylea outperformed Lucentis at the one-year time point, no statistical difference in visual acuity was observed between the two groups at year 2.

At the end of the trial, the average visual acuity was in the range of 20/32 to 20/40 among participants in all three groups.

Eylea participants were able to read about 3.5 additional lines on an eye chart; Lucentis participants were able to read about three additional lines, and Avastin participants improved about 2.5 lines, compared with visual acuity before treatment, according to the study.

The Eylea group had the least percentage of participants who received laser treatment to treat their macular edema - say 41% while it was 64% in the Avastin group and 52% in the Lucentis group.

The Lucentis group accounted for a higher risk of heart attack, stroke, or death from a cardiovascular condition or an unknown cause compared to the Eylea or Avastin groups, which according to researchers warrants further probe in future trials.

Commenting on the findings, John Wells, the lead author of the study, said, "The results of the DRCR Network's comparison of Eylea, Avastin, and Lucentis will help doctors and their patients with diabetic macular edema choose the most appropriate therapy."

The results of the study are published in Ophthalmology, the journal of the American Academy of Ophthalmology.