Switching Anti-VEGF Drugs in the Treatment of Diabetic Macular Edema

Ophthalmic Surg Lasers Imaging Retina. 2017 Sep 1;48(9):748-754. doi: 10.3928/23258160-20170829-10.

Abstract

Since their introduction in the late 2000s, anti-vascular endothelial growth factor (VEGF) agents have become the first-line choice for center-involved diabetic macular edema (DME). Even with its proven effectiveness, there are still cases that do not respond satisfactorily. In those cases, a treatment option is to change to another anti-VEGF drug. In this paper, the authors review studies on switching between different anti-VEGF drugs in the treatment of persistent DME. An extensive bibliographic review was done using PubMed, Embase, and Scopus. Fourteen studies published from March 2010 to April 2017 reporting switching from anti-VEGF drugs in DME treatment were included. All reported good anatomical results after conversion; however, visual acuity outcomes showed great variability between publications. Therefore, switching to other anti-VEGFs in patients with DME not responding to previous anti-VEGF therapy may be an option, but the results are still not well-known due to a lack of randomized clinical trials. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:748-754.].

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use*
  • Bevacizumab / administration & dosage
  • Diabetic Retinopathy / drug therapy*
  • Drug Substitution*
  • Humans
  • Intravitreal Injections
  • Macular Edema / drug therapy*
  • Ranibizumab / administration & dosage
  • Receptors, Vascular Endothelial Growth Factor / administration & dosage
  • Recombinant Fusion Proteins / administration & dosage
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Recombinant Fusion Proteins
  • Vascular Endothelial Growth Factor A
  • aflibercept
  • Bevacizumab
  • Receptors, Vascular Endothelial Growth Factor
  • Ranibizumab