BMJ open ophthalmology · 2025
Anti-VEGF treatment switch in real-world DME patients: ranibizumab versus aflibercept for bevacizumab DME non-responding patients (SWIRL study).
СтатьяСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lim Louis W, Choy Darren, Song Wen Jun, Ngo Wei Kiong, Thng Zheng Xian, Mi Helen Fang, Soh Yu Qiang, Lilian Koh, Chin Jacob Yu Hang, Chia Karen Jhi Wen, Laude Augustinus, Tan Colin S, Lim Tock Han, Too Issac, Gan Nicola Y, Rajagopalan Rajesh
Аннотация
BACKGROUND/AIMS: To describe the functional outcomes of patients with diabetic macular oedema (DME) non-responsive to bevacizumab switched to ranibizumab or aflibercept over 1 year and the demographic and anatomic predictors of these functional outcomes.
METHODS: In a retrospective real-world cohort study, 76 consecutive patients with DME non-responsive to bevacizumab were reviewed at baseline and 12 months after switch to ranibizumab or aflibercept. Visual acuity (VA) and optical coherence tomography features such as central retinal thickness were assessed. Multiple logistic regression was performed to determine predictors for outcomes.
RESULTS: From baseline to 1 year, the overall best-corrected VA improved by LogMAR 0.015±0.19 with no difference between patients who switched to ranibizumab or aflibercept (LogMAR 0.017±0.21 vs LogMAR 0.013±0.17, p=0.92). Ranibizumab patients had more reduction in central subfield thickness (CST) (390.13 µm vs 334.20 µm, p=0.033) than aflibercept patients. Baseline HbA1c (p=0.012) and number of bevacizumab injections (p=0.040) were significantly associated with gain in VA, while change in CST was a strong predictor of VA change (p<0.01). Aflibercept patients were more likely to gain vision after 6 months but not at 12 months.
CONCLUSIONS: In a real-world study, improvements in functional outcomes can still be gained after switching anti-vascular endothelial growth factor in bevacizumab non-responders. Both ranibizumab and aflibercept were comparable and effective treatments.
METHODS: In a retrospective real-world cohort study, 76 consecutive patients with DME non-responsive to bevacizumab were reviewed at baseline and 12 months after switch to ranibizumab or aflibercept. Visual acuity (VA) and optical coherence tomography features such as central retinal thickness were assessed. Multiple logistic regression was performed to determine predictors for outcomes.
RESULTS: From baseline to 1 year, the overall best-corrected VA improved by LogMAR 0.015±0.19 with no difference between patients who switched to ranibizumab or aflibercept (LogMAR 0.017±0.21 vs LogMAR 0.013±0.17, p=0.92). Ranibizumab patients had more reduction in central subfield thickness (CST) (390.13 µm vs 334.20 µm, p=0.033) than aflibercept patients. Baseline HbA1c (p=0.012) and number of bevacizumab injections (p=0.040) were significantly associated with gain in VA, while change in CST was a strong predictor of VA change (p<0.01). Aflibercept patients were more likely to gain vision after 6 months but not at 12 months.
CONCLUSIONS: In a real-world study, improvements in functional outcomes can still be gained after switching anti-vascular endothelial growth factor in bevacizumab non-responders. Both ranibizumab and aflibercept were comparable and effective treatments.
Предметные рубрики MeSH
HumansRanibizumabReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsMaleBevacizumabRetrospective StudiesFemaleAngiogenesis InhibitorsVisual AcuityDiabetic RetinopathyMacular EdemaTomography, Optical CoherenceIntravitreal InjectionsMiddle AgedVascular Endothelial Growth Factor ADrug SubstitutionAgedTreatment OutcomeFollow-Up Studies