Ranibizumab reduces progression of diabetic retinopathy

May 8, 2012

Intravitreal ranibizumab (Lucentis, Genentech) reduced the risk and rate of progression of diabetic retinopathy in eyes with diabetic macular edema (DME), and many eyes treated with ranibizumab had improvements in the severity of the diabetic retinopathy, said Michael Ip, MD.

Fort Lauderdale, FL-Intravitreal ranibizumab (Lucentis, Genentech) reduced the risk and rate of progression of diabetic retinopathy in eyes with diabetic macular edema (DME), and many eyes treated with ranibizumab had improvements in the severity of the diabetic retinopathy, said Michael Ip, MD.

While studies have reported the efficacy of ranibizumab for treated DME, Dr. Ip wanted to know if the drug can prevent progression of the severity of diabetic retinopathy and induce regression of the severity of diabetic retinopathy. Dr. Ip is affiliated with the Department of Ophthalmology, University of Wisconsin-Madison.

Dr. Ip and his colleagues evaluated the effects of ranibizumab on the severity of diabetic retinopathy over time in two phase III clinical trials of the drug evaluated for treating DME, the RISE and RIDE studies.

In those two double-masked, sham-controlled, multicenter trials, a total of 759 patients randomly received monthly 0.3- or 0.5-mg injections of intravitreal ranibizumab or sham injections monthly to evaluate the drug’s effect on DME. Dr. Ip analyzed the diabetic retinopathy severity in those patients, specifically at two or greater or three or greater steps in changes in the severity of diabetic retinopathy and the development of vitreous hemorrhages and the need for panretinal photocoagulation (PRP).

Dr. Ip noted that at 2 years, ranibizumab had a protective effect compared with the sham group. Worsening of diabetic retinopathy was significantly lower and improvement was significantly higher in the ranibizumab-treated eyes compared with the sham-treated eyes.

He concluded that “ranibizumab decreased the risk and rate of progression of diabetic retinopathy and increased the chances of improvement of the severity level of diabetic retinopathy. Ranibizumab was highly effective for reducing the severity of diabetic retinopathy.”

Dr. Ip advised that PRP is still the mainstay of treatment and that ranibizumab should not be the primary treatment for diabetic retinopathy severity, particularly in patients without macular edema. Ranibizumab can be combined with focal laser treatment to achieve these potential beneficial effects.

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