Comparison of the effectiveness of ranibizumab and pegaptanib sodium in the treatment of diabetic macular edema


Authors: Jana Štefaničková;  Jaroslav Hasa
Authors‘ workplace: Klinika oftalmológie LF UK a UNB, Nemocnica Ružinov, Bratislava
Published in: Forum Diab 2017; 6(1): 20-26
Category: Topic

Overview

Objective:
To review the effectiveness of ranibizumab and pegaptanib sodium in the treatment of diffuse diabetic macular edema in a loading dose (3 injections).

Materials and Methods:
Patients with diffuse diabetic macular edema, central macular thickness (CMT) ≥ 250 μm and best-corrected visual acuity (BCVA) between 39 and 73 letters were prospectively divided into 2 groups according to the applied drug – ranibizumab (ranibizumab 0.5 mg) and pegaptanib (pegaptanib sodium 0.3 mg). According on the application schema for monitored drugs eyes treated with ranibizumab were evaluated at 4, 8 and 12 weeks and eyes treated with pegaptanib sodium after 6, 12 and 18 weeks. Best-corrected visual acuity, CMT and macular volume werere followed – up.

Results:
Prospective study enrolled 20 patients/21 eyes with diffuse DEM group ranibizumab 11 eyes and group pegaptanib 10 eyes. The value of HbA1c were 7.55, 7.95 respectively. The ranibizumab group, the baseline BCVA was 51.9 letters CMT 553.45 μm and macular volume 10.68 mm3. After 12 weeks BCVA increased +11.2 letters, mean change CMT -135.9 μm and macular volume -1.62 mm3. In the group pegaptanib baseline BCVA was 54.1 letters CMT 499,6μm and macular volume 10.4 mm3. After 18 weeks BCVA increased +3.25 letteres, mean change CMT +4.38 μm, and macular volume -0.56 mm3. In ranibizumab group, 29 injections were administered. In 4 eyes after the initial two applications treatment was discontinued in accordance with criteria to discontinue treatment (CMT ≤ 250 μm or BCVA ≥ 84 letters). In pegaptanib group 28 injections were administered, 1 patient died of cardiac failure after 10 weeks of treatment initiation.

Conclusion:
Intravitreal antivascular endothelial growth factors in the treatment of diabetic macular edema improves visual acuity and reduces central thickness and macular volume on OCT. In this study ranibizumab 0.5 mg demonstrated superior efficacy to pegaptanib sodium 0.3 mg after the initial three doses.

Key words:
diabetic macular edema, ranibizumab, pegaptanib

Received:
30. 12. 2016

Accepted:
17. 2. 2017


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Diabetology Endocrinology Internal medicine
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