A new study suggests that women with diabetic macular edema (DME) respond better than men to intravitreal bevacizumab. The anti-VEGF drug also had a stronger impact on those with diffuse retinal thickening. At the same time, the study found that the injections did not help and, in fact, may have worsened things for patients with proliferative diabetic retinopathy (PDR).
The Malta-based researchers reviewed the records of 65 eyes with DME secondary to type 2 diabetes. Males comprised 63% of the cohort and females comprised 37%. The patients all received bevacizumab shots for the first time in 2016. They noted the changes to the central macular thickness (CMT), macular volume and best-corrected visual acuity (BCVA) following three injections. Glycemic control, diabetic retinopathy grade, DME subtype on OCT and past macular laser therapy were also all taken into account.
The mean baseline CMT was 443.21μm, and the researchers noted a mean reduction of 11.23%. The women exhibited a greater reduction in CMT, and participants with diffuse retinal thickening and CME showed a net reduction in CMT of 17.39% and 8.24%, respectively. However, eyes with PDR actually demonstrated a mean gain in CMT of 16.86%.
These findings should be considered in clinical decision-making when opting for anti-VEGF therapies, the investigators suggest.
|Bezzina D, Carbonaro F. Factors predicting treatment response in anti-vascular endothelial growth factor naïve diabetic macular edema patients treated with intravitreal bevacizumab. J Ocul Pharmacol Ther. October 11, 2019. [Epub ahead of print].|